Antenatal administration of granulocyte-macrophage colony-stimulating factor increases fetal lung maturation and endothelial nitric oxide synthase expression in the fetal rat lung

Objective

To study subsequent pregnancy outcome in women with severe, very early onset preeclampsia (onset before 24 weeks’ gestation) and to analyze cardiovascular risk profiles of these women and their partners.

Study design

Twenty women with preeclampsia with an onset before 24 weeks’ gestation, admitted between 1 January 1993 and 31 December 2002 at a tertiary university referral center, were enrolled in the study. Data on subsequent pregnancies were obtained from medical records. Their cardiovascular risk profiles and those of their partners (n = 15) were compared with those of 20 control women after uncomplicated pregnancies only, matched for age and parity, and those of their partners (n = 13). Body weight, height, waist and hip circumference, blood pressure and intima media thickness (IMT) of the common carotid artery were measured. Fasted blood samples were drawn for detection of metabolic cardiovascular risk factors.

Results

Of the 20 case women 17 women had 24 subsequent pregnancies, of which 12 (50%) were complicated by preeclampsia. Severe preeclampsia developed in five (21%) pregnancies. No perinatal deaths occurred. Case women had significantly more often chronic hypertension as compared to controls (55% vs. 10%, P = 0.002). IMT of the common carotid artery was increased in a subset of case women using antihypertensive medication (P = 0.03). Case women showed increased microalbuminuria (P < 0.05). No differences were found in cardiovascular risk profiles between partners of cases and controls.

Conclusions

Women with severe, very early onset preeclampsia have an increased risk of preeclampsia in future pregnancies, yet neonatal outcome is, in general, favourable. Regarding cardiovascular health, women after severe, very early onset preeclampsia exhibit more risk factors compared to controls whereas men who fathered these pregnancies do not.     

Pregnancy outcomes in women with severe needle phobia

Objectives

Needle phobia in pregnancy poses a problem as women may refuse medical care because of their fear. The present study investigates the impact of needle phobia on the antenatal and intrapartum care of needle phobic women and reports on the pregnancy and neonatal outcomes.

Study design

A retrospective cohort of 112 cases, divided into severe and mild cases of needle phobia, was collected from the anaesthetic referral database. The data were collected manually as well as by using the computerised hospital database, and were analysed using SPSS version 19. Chi-square analysis and unpaired t-test were used to analyse categorical and continuous variables, respectively. The overall departmental statistics for 2009 and 2010 were used as a comparator.

Results

Women with severe needle phobia, compared to those with mild needle phobia, registered late with the antenatal services (17 weeks vs 14 weeks, p < 0.05), had a significant delay in obtaining their first antenatal blood tests (25 weeks vs 15 weeks, p < 0.0001), consented less often to the booking blood tests (62.8% vs 98.6%, p < 0.0001) and antenatal tests (30.2% vs 76.8%, p < 0.0001), had low use of pethidine (4.7% vs 24.6%, p < 0.01) and a higher demand for general anaesthesia (11.6% vs 0%, p < 0.01) and had an increased number of physiological deliveries of the placenta (37.2% vs 8.7%, p < 0.0001). The incidence of maternal and neonatal adverse outcomes in both groups was low.

Conclusion

Despite the differences in choice of analgesia and acceptance of routine blood tests, pregnancy outcomes in women with severe needle phobia were good. The study highlighted the importance of adequate risk assessment of all women disclosing their needle phobic status, and of provision of high-standard multidisciplinary care involving primary and secondary healthcare professionals.     

Assessment of preoperative serum prolidase activity in epithelial ovarian cancer

Objective

Prolidase is a cytosolic exopeptidase that cleaves iminodipeptides with C-terminal proline and hydroxyproline and plays a major role in collagen turnover. The aim of this study was to evaluate preoperative serum prolidase activity, total oxidant status (TOS), and total antioxidant capacity (TAC) in patients with newly diagnosed epithelial ovarian cancer (EOC).

Study design

Serum prolidase activity, TOS, and TAC were measured spectrophotometrically in both EOC cases (n = 28) and controls (n = 28).

Results

Preoperative serum prolidase activity and TOS were significantly higher in patients with EOC compared to controls (p = 0.009 and 0.008, respectively), whereas TAC was significantly lower in cases (p < 0.001). A significant positive correlation was found between the stage, grade, and CA-125 level of EOC and serum prolidase activity (rho = 0.466, p = 0.012; rho = 0.501, p = 0.007; and rho = 0.447, p = 0.017, respectively) and TOS (rho = 0.588, p = 0.001; rho = 0.412, p = 0.029; and rho = 0.568, p = 0.002, respectively). In contrast, there was a negative correlation between TAC and the stage, grade, and CA-125 level of EOC (rho = −0.555, p = 0.002; rho = −0.566, p = 0.002; and rho = −0.581, p = 0.001, respectively).

Conclusion

Findings of the present study demonstrate that serum prolidase activity is significantly associated with the stage, tumor grade, and preoperative CA-125 level of EOC.     

Effect of tamoxifen on extracellular signal-regulated kinases in the urethra of castrated female rats

Objective

To explore the role of primary physicians in the diagnostic delay of lower urinary tract and pelvic organ prolapse symptoms in parous women.

Study design

Prospective cohort study of women referred to the Urogynecology Outpatient Clinic of a major medical center by primary physicians in the community for initial assessment of lower urinary tract and pelvic organ prolapse symptoms.

Results

Most of the women blamed themselves for the delay. However, the primary physicians were considered responsible for 33.5% of the delays. There was no between-group differences in self-blame (p = 0.438). Women with pelvic organ prolapse blamed the gynecologist significantly more often than women with lower urinary tract symptoms (p = 0.043); 38.6% of the physicians considered the symptoms not sufficiently severe or a natural part of aging.

Conclusion

Patients need to receive more information on the availability of specific evaluations and treatments for pelvic floor dysfunction.     

Is preeclampsia associated with higher frequency of HSP70 gene polymorphisms?

Aim

To evaluate the possible association of three different HSP70 gene polymorphisms with preeclampsia.

Study design

HSPA1A G(190)C, HSPA1B A(1267)G and HSPA1L T(2437)C polymorphisms were analyzed from blood samples of 72 women with preeclampsia and of 70 healthy pregnant women as controls by PCR-RFLP method.

Results

HSPA1B (1267)GG and HSPA1L (2437)CC genotypes occurred more frequently in preeclamptic patients compared to healthy controls (p < 0.002 [RR: 4.38, 95% CI: 1.56–12.28]) and (p < 0.03 [RR: 1.31, 95% CI: 1.03–1.67]), respectively. Significant difference was found in the distribution of HSPA1B A(1267)G genotype between the preeclamptic and control group (p < 0.004 [RR: 0.67, 95% CI: 0.51–0.88]). Distribution of HSPA1A G(190)C was similar in the preeclamptic and control group. In controls, genotype distribution of HSPA1A G(190)C and HSPA1L T(2437)C was in Hardy–Weinberg equilibrium, while this criterion was not fulfilled for HSPA1B A(1267)G.

Conclusion

We concluded that HSPA1B (1267)GG and HSPA1L (2437)CC genotypes were more frequent among preeclamptic than control patients, suggesting that these genotypes may play a role in the susceptibility for preeclampsia.     

Relationship of serum adipocyte-derived proteins with insulin sensitivity and reproductive features in pre-pubertal and pubertal daughters of polycystic ovary syndrome women

Objective

To evaluate in a cross-sectional study adiponectin and leptin levels in prepubertal and pubertal daughters of women with PCOS and their relationship to insulin sensitivity and reproductive features.

Study design

We studied 92 daughters of PCOS women (PCOSd) and 76 daughters of control women (Cd) matched by age and body mass index SD scores and distributed according to breast Tanner stage: prepuberty (Tanner 1), early puberty (Tanner 2–3) or late puberty (Tanner 4–5). In all girls an oral glucose tolerance test was performed. Leptin, adiponectin, sex steroids, SHBG, glucose, insulin and lipid profile were determined. Leptin–adiponectin ratio, free androgen index and insulin sensitivity (HOMA-IR and ISI composite) were then calculated.

Results

Prepubertal PCOSd showed lower serum adiponectin compared to Cd (p = 0.028), whereas during puberty no differences were observed between the groups. Leptin concentrations were similar in both groups in all Tanner stages. In addition, in PCOSd during early puberty, adiponectin showed a negative correlation with testosterone and leptin showed a negative correlation with ISI composite, which were independent of BMI SDS (r = −0.39; p = 0.02 and r = −0.42; p = 0.01).

Conclusion

These observations suggest that during the prepubertal period PCOSd exhibit abnormal adiponectin levels, independently of BMI. Moreover, leptin and adiponectin may be related to metabolic and reproductive abnormalities observed in PCOSd during the early stages of sexual development.     

Mannose-binding lectin codon 54 genetic polymorphism and vaginal protein levels in women with gynecologic malignancies

Objectives

Mannose-binding lectin (MBL), an innate immune system component that binds to carbohydrates, activates the complement cascade and promotes destruction of microorganisms and abnormal cells. We determined whether a polymorphism in the MBL gene influences vaginal MBL protein concentrations and the occurrence of gynecologic malignancies.

Study design

DNA from 289 women seen in a gynecologic oncology practice and from 126 healthy women was tested for an MBL codon 54 single nucleotide polymorphism by polymerase chain reaction and endonuclease digestion. Vaginal supernatants from 282 of these women were assayed for MBL protein by ELISA.

Results

The normal (A,A) genotype was present in 84.1% of 126 healthy women and 85.3% of 95 women with a benign diagnosis as opposed to 70.0% of 70 women with ovarian cancer (p = 0.02). The MBL variant allele (allele B) frequency was 8.7% in healthy women, 8.4% in women with a benign diagnosis and 17.1% in women with ovarian cancer (p = 0.02). Vaginal MBL protein concentrations were highest in women with the A,A genotype, intermediate in A,B heterozygotes (p < 0.0001) and lowest in B,B homozygotes (p = .0097).

Conclusion

The MBL 54 polymorphism and reduction in vaginal MBL concentrations may be a risk factor for development of epithelial ovarian cancer.     

First-trimester maternal serum metastin, placental growth factor and chitotriosidase levels in pre-eclampsia

Objective

To investigate whether the serum levels of metastin and PIGF and chitotriosidase activity early in pregnancy differ in women who develop pre-eclampsia from those who remain normotensive.

Study design

A retrospective case–control study of prospectively collected data. Thirty healthy pregnant women and 31 women with pre-eclampsia were included in the study. Serum samples were collected at 11–14 weeks and stored at −70 °C. Levels of metastin, PIGF and chitotriosidase activity were measured in serum from pregnant women with subsequent development of pre-eclampsia and matched controls.

Results

Mean maternal serum metastin (1554 ± 385 pmol/L vs 1995 ± 375 pmol/L, p < 0.001) and PIGF (111.9 ± 7.0 pg/mL vs 124.9 ± 13.5 pg/mL, p < 0.001) levels were significantly lower and chitotriosidase activity was significantly higher (681.6 ± 248.3 nmol/mL/h vs 527.7 ± 223.1 nmol/mL/h, p < 0.01) in women who subsequently developed pre-eclampsia than in those who remained normotensive. The areas under the curve equal to 0.797, 0.831 and 0.681 (p < 0.001, p < 0.001 and p < 0.01) for metastin, PIGF, and chitotriosidase respectively were determined for the prediction of pre-eclampsia.

Conclusions

Metastin and PIGF levels and chitotriosidase activity are altered in the first trimester serum of women destined to become pre-eclamptic, reflecting placental dysfunction. Metastin, like PIGF, may have a potential to be used as a first-trimester biomarker of pre-eclampsia.     

Does 45,X/46,XX mosaicism with 6–28% of aneuploidy affect the outcomes of IVF or ICSI?

Objective

Several studies have shown an increased frequency of chromosomal aberrations in female partners of couples examined prior to intracytoplasmic sperm injection (ICSI). A retrospective cohort study was performed to determine whether 45,X/46,XX mosaicism affects the outcomes of in vitro fertilization (IVF) or ICSI.

Study design

Forty-six women with a 45,X/46,XX karyotype with 6–28% of aneuploidy were compared with 59 control women (46,XX), matched for age, from the female population who underwent IVF or ICSI between 1 January 1996 and 31 December 2006 at the Reproductive Medicine Unit at Brest University Hospital. The outcomes of 254 treatment cycles were compared according to patient karyotype.

Results

No difference was found in the number of retrieved oocytes (8.9 ± 5.5 vs 8.5 ± 4.7; p = 0.56) or the number of mature oocytes (7.4 ± 4.7 vs 6.9 ± 4.2; p = 0.49) between the 45,X/46,XX group and the 46,XX group, respectively. Fertilization rates did not differ between the groups for either IVF or ICSI. In addition, no difference was found in the pregnancy rate by cycle (17.4% vs 18.7%, respectively; p = 0.87). The percentage of first-trimester miscarriages was similar in both groups (13.6% vs 12.5%, respectively; p = 0.51).

Conclusion

45,X/46,XX mosaicism with 6–28% of aneuploidy has no adverse effect on the outcomes of IVF or ICSI among women referred to assisted reproductive technologies.     

Laparoscopic uterine nerve ablation versus vaginal uterosacral ligament resection in postmenopausal women with intractable midline chronic pelvic pain: a randomized study

Objective

To assess and compare the laparoscopic uterine nerve ablation (LUNA) and the vaginal uterosacral ligament resection (VUSR) in postmenopausal women with chronic pelvic pain (CPP).

Study design

Eighty postmenopausal women with intractable and severe midline CPP were randomized to undergo LUNA or VUSR. Costs of two surgical procedures were assesses. Cure rate, severity of CPP, and deep dyspareunia were also evaluated after 6 and 12 months from surgery.

Results

The mean cost of LUNA resulted significantly higher in comparison with VURS (2078 ± 637 versus 1497 ± 297, P < 0.001). The cure rate was not significantly different between the two groups at 6 (33/40, 82.5% versus 35/40, 87.5% for groups A and B, respectively; P = 0.530; RR 0.94, 95% CI 0.78–1.13), and 12 months (27/36, 75.0% versus 28/38, 73.7%, for groups A and B, respectively; P = 0.901; RR 0.90, 95% CI 0.78–1.33) of follow-up. At same times, a significant (P < 0.01) decrease in severity of CPP and deep dyspareunia was observed in both groups with no difference between them.

Conclusions

Both LUNA and VUSR are equally effective surgical treatments in postmenopausal women with central CPP but VUNR is significantly cheaper than LUNA.     

Is there any relation between IL-6 gene −174 G>C polymorphism and postmenopausal osteoporosis?

Objective

IL-6 gene single nucleotide polymorphisms (SNPs) have been reported to have a protective effect against bone resorption. We aimed to investigate the association between bone mineral density and IL-6 promoter region −174 G>C SNP.

Study design

This study included 356 postmenopausal Turkish women, of whom 201 were osteoporotic (lumbar spine T score < −2.5 SD) and 155 non-osteoporotic (lumbar spine T score > −1.5 SD). Bone mineral density (BMD) measures were obtained using dual-energy X-ray absorptiometry. SNP of the IL-6 gene (−174 G>C) was examined by polymerase chain reaction-restriction fragment length polymorphism.

Results

The frequencies of the variant C allele (24% vs. 30%, p = 0.074) and mutant CC genotype (12% vs. 20%, p = 0.094) were higher in non-osteoporotic women. Lumbar spine and total hip BMD values were lowest among women with the G/G genotype, intermediate in the heterozygotes, and highest in women with the C/C genotype. The GG (p = 0.022) and GC (p = 0.037) genotypes were covariates which approached statistical significance in the regression model fitting of BMD.

Conclusion

IL-6 promoter region SNP showed an association with BMD in this postmenopausal Turkish population and these data suggest that the wild GG genotype influences the phenotype.     

Micropartículas plaquetarias en preeclampsia y eclampsia

Objective

To compare platelet microparticle values in eclamptic, preeclamptic and normotensive pregnant women.

Material and methods

Patients attending the Dr. Urquinaona Central Hospital in Maracaibo, Venezuela, were selected. Thirty patients with mild preeclampsia (group A), 30 with severe preeclampsia (group B) and 30 with eclampsia (group C) were included. Thirty-five healthy women with a similar age and body mass index to those in the study groups were selected as controls (group D). Only nuliparous patients were included. Blood samples were collected before delivery from all patients and immediately after diagnosis for platelet microparticle determination in the study groups.

Results

Statistically significant differences were found in gestational age between groups B and C compared with the control group (P < .05). Higher platelet microparticle values were found in eclamptic patients and severe preeclamptic patients. Lower values were found in mild preeclamptic patients. Significantly higher platelet microparticle values were found in the study groups than in controls (P < .05). When linear regression was performed, the factors significantly affecting platelet microparticle values were 24-hour proteinuria, transaminase and uric acid levels and platelet count (P < .05).

Conclusions

Our findings indicate that platelet microparticle values are higher in eclamptic and preeclamptic women than in normotensive pregnant women.     

Interleukin 18 messenger RNA and proIL-18 protein expression in chorioamniotic membranes from pregnant women with preterm prelabor rupture of membranes

Objective

To quantify the expression of IL-18 mRNA and protein in the chorioamniotic membranes of pregnant women with PPROM and correlate expression with histological chorioamnionitis.

Study design

A case control study that included 42 pregnant women not in labor in the following groups: PPROM (n = 28) and controls with intact membranes submitted to selective cesarean section at term (n = 14). Expression of IL-18 mRNA in chorioamniotic membranes was determined by real-time polymerase chain reaction, and IL-18 protein expression was measured by western blot. Histopathological analyses and immunolocalization of IL-18 by immunohistochemistry were also performed. Analyses were performed using the Mann–Whitney or Fisher's exact tests and the group effect was considered significant if the adjusted p-values were <0.05 and the magnitude of change was greater than 2-fold for mRNA expression.

Results

IL-18 mRNA was present in 100% of samples and no difference in expression was observed between term vs. PPROM membranes (fold-change 0.12; p = 0.88). In the PPROM group, no difference was observed in IL-18 mRNA regarding gestational age (fold-change 0.11; p = 0.42) or the presence of histological chorioamnionitis (fold-change 0.26; p = 0.15). ProIL-18 was present in all samples. IL-18 was immunolocalized to amnion, chorion and decidua cells, with intense immunohistochemical staining at the choriodecidual junction.

Conclusion

Chorioamniotic membranes are sources of IL-18 mRNA and proIL-18, and their expression is unrelated to PPROM or histological chorioamnionitis.     

Factor de crecimiento de hepatocitos plasmático en preeclampsia y eclampsia

Objective

To compare plasma hepatocyte growth factor concentrations in eclamptic, preeclamptic and normotensive pregnant women.

Materials and method

We included 30 patients with mild preeclampsia (group A), 30 patients with severe preeclampsia (group B) and 30 patients with eclampsia (group C). A control group of 30 healthy pregnant women (group D) was selected with a similar age and body mass index to participants in the study groups. Only nulliparous patients were included. Blood samples were collected for plasma hepatocyte growth factor determination in all patients before delivery and in the study groups immediately after diagnosis.

Results

Plasma hepatocyte growth factor values were highest in eclamptic patients and in severe preeclamptic patients and were lowest in mild preeclamptic patients. Hepatocyte growth factor values were significantly higher in the study groups than in controls (P<.05). Linear regression analysis revealed that 24-hour proteinuria significantly affected plasma hepatocyte growth factor concentrations (P<.05).

Conclusion

The findings of this research showed that plasma hepatocyte growth factor concentrations were higher in eclamptic and preeclamptic patients than in normotensive pregnant women.     

L-arginine pathway in neonates with meconium-stained amniotic fluid

Objective

To study the arginase, nitric oxide synthase and nitric oxide pathways associated with passage of meconium.

Study design

Cord blood samples were collected from 20 newborns with meconium-stained amniotic fluid (MSAF) and from 23 newborns with clear amniotic fluid. Cord blood pH, arginase, nitric oxide synthase and nitric oxide levels were compared between the groups.

Result

The differences between the arginase and nitric oxide measurements of the newborns with MSAF and those with clear amniotic fluid were significant. In the MSAF group arginase levels were significantly lower (p = 0.007) and nitric oxide levels were significantly higher (p = 0.032) than the clear amniotic fluid group.

Conclusion

Hypoxia may be involved in the pathogenesis of meconium passage due to decreased arginase and increased nitric oxide levels.     

A randomised controlled trial evaluating the effect of immersion bath on labour pain

Objective

to evaluate the effect of an immersion bath on pain magnitude during the first stage of labour.

Design

a randomised controlled trial comparing the pain scores of bathing and non-bathing nulliparous women during birth was employed.

Setting

the study was conducted at the Normal Birth Center of Amparo Maternal, São Paulo, Brazil.

Participants

108 birthing women, with 54 women randomly assigned to each group.

Interventions

when the birthing women presented at 6–7 cm of cervical dilation, they were placed in an immersion bath for 60 mins.

Outcome measures

pain scores, using a behavioural pain scale and a numeric scale, were recorded at two evaluation time points: at 6–7 cm of cervical dilation and 1 h after the first pain score evaluation.

Findings

at the first evaluation, on the behavioural scale, the means were 2.1 for both groups (p=0.914; 95% confidence intervals (CI) 1.9–2.3 for the control group and 2.0–2.2 for the experimental group). On the numeric scale, the means were 8.7 and 8.5 for the control and experimental groups, respectively (p=0.235; 95% CI 8.2–9.2 for the control group and 8.1–8.9 for the experimental group). At the second evaluation, the pain score means for both scales were statistically higher in the control group than in the experimental group. On the behavioural scale, the scores were 2.4 vs. 1.9, respectively, for the control and experimental groups (p<0.001; 95% CI 2.2–2.6 for the control group and 1.7–2.1 for the experimental group). On the numeric scale, the scores were 9.3 vs. 8.5, respectively, for the control and experimental groups (p<0.05; 95% CI 8.9–9.7 for the control group and 8.1–8.9 for the experimental group).

Conclusions

mean labour pain scores in the control group were significantly higher than those in the experimental group. The present findings suggest that use of an immersion bath is a suitable alternative form of pain relief for women during labour.     

Weight retention from early pregnancy to three years postpartum: a study in Iranian women

Objectives

to examine weight retention from early pregnancy to three years postpartum in Iranian women.

Design

a prospective cohort study.

Setting

12 health centres selected at random in urban and rural areas in Guilan.

Participants

1315 pregnant women (705 in urban areas and 610 in rural areas) who regularly attended health centres for antenatal care and growth monitoring of their babies.

Measurements

details of weight, height, pregnancy weight gain, body weight at one to three years postpartum, mother's age, parity, duration of any breast feeding, education and employment status of women who carried singleton fetuses and delivered at term were collected at the first antenatal visit. The women were categorised based on their pre-pregnancy body mass index, weight retention at one to three years postpartum, employment status and educational levels.

Findings

women who gained more weight than recommended during pregnancy tended to be heavier at three years postpartum than women who gained weight within the recommended ranges during pregnancy (7.0±5.3 versus 4.8±6.7 kg; p<0.0001). Less-educated women were at greater risk for inadequate pregnancy weight gain than other educational groups, and they had less weight retention at three years postpartum than other educational groups. Also, weight retention for primiparous women was higher than that for multiparous women (5.4±6.6 versus 3.8±6.3 kg; p<0.0001). The results of logistic regression analysis revealed that only total pregnancy weight gain was independently related to major weight retention (?4 kg) at three years postpartum (odds ratio 1.34, 95% confidence intervals 1.03–1.74; p=0.02).

Conclusion

a high body mass index before pregnancy is not associated with increased risk of retaining more weight after pregnancy. On the other hand, total pregnancy weight gain was the most important determinant of weight retention at three years postpartum in this population of Iranian women.     

The effect of chemotherapy or radiotherapy on thymidine phosphorylase and dihydropyrimidine dehydrogenase expression in cancer of the uterine cervix

Objective

To evaluate the feasibility in everyday practice and the advantages of salpingectomy for ectopic pregnancy by single-incision laparoscopic surgery with the SILS^® system.

Study design

This single-center prospective observational study included 37 women requiring salpingectomy for ectopic pregnancy who underwent single-incision laparoscopic salpingectomy with the SILS^® system. Information about feasibility and intra- and post-operative data were collected. The data for these patients were compared with those of a control group of 40 women treated by standard laparoscopy.

Results

Thirty-six (97%) patients were treated successfully with the SILS^® system. After laparoscopic confirmation of the ectopic pregnancy, salpingectomy was performed with bipolar forceps and scissors. In one case, conversion to classic laparoscopy was performed because SILS was not feasible. Compared with the control group, operative time was longer (50 ± 35 vs 35 ± 30 min, p = 0.001) but duration of hospitalization shorter with single-site laparoscopy (1.5 ± 1.5 vs 2.3 ± 1.5 days, p = 0.02).

Conclusions

Laparoscopic salpingectomy for ectopic pregnancy appears to be feasible in everyday practice by single-incision laparoscopic surgery with the SILS^® system and appears to reduce the duration of hospitalization. Larger series are necessary to confirm this conclusion.     

Randomized, double-blind, placebo-controlled study of oral lactobacilli to improve the vaginal flora of postmenopausal women

Objective

The purpose of this randomized, double-blind, placebo-controlled study was to evaluate the influence of the orally administered probiotic strains Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 on the quality of the vaginal flora in postmenopausal women.

Study design

Postmenopausal women with Nugent scores between 4 and 6 in initial vaginal swab, were randomized into two groups. Women in the intervention group received probiotic capsules containing 2.5 × 10⁹ CFU (colony forming units) each of lyophilized L. rhamnosus GR-1 and L. reuteri RC-14 and women in the control group received an oral placebo once daily, in both groups for 14 days. Final vaginal swabs were taken 1 day after the last administration of the medication. The primary efficacy variable was a change in the Nugent score between baseline and the end of the study of at least two grades in each individual patient.

Results

Seventy two women were recruited in the study, 35 assigned to the intervention group and 37 to the control group. Twenty-one of the 35 subjects (60%) in the intervention group and 6 of the 37 subjects (16%) in the control group showed a reduction in the Nugent score by at least two grades. The difference in the number of patients with improvement was highly significant (p = 0.0001). The median difference in Nugent scores between baseline and the end of the study was 3 in the intervention group and 0 in the control group (p = 0.0001).

Conclusion

Our results provide evidence for an alternative modality to restore the normal vaginal flora using specific probiotic strains administered orally.     

A prospective randomized study to compare four different mineral oils used to culture human embryos in IVF/ICSI treatments

Objective(s)

We aimed to evaluate and compare the embryo quality at early cleavage stages using different oils overlaying media to culture human embryos during IVF/ICSI treatments.

Study design

A total of 500 IVF/ICSI treatments from 500 women were analyzed in a prospective randomized study. Oocytes/embryos were treated into microdroplets of appropriate media overlaid with (i) Mineral Oil (CryoBioSystem, L’Aigle, France) (group 1, n = 129), (ii) Liquid Paraffin (Medicult, Lyon, France) (group 2, n = 126), (iii) Nidoil (Nidacon International, Guthenburg, Sweden) (group 3, n = 126) and (iv) Ovoil (Vitrolife, Kungsbacka, Sweden) (group 4, n = 119). Comparisons between groups were done using two by two post hoc tests, with 5% significance. The primary endpoint was the embryo quality, defined as good or top quality when embryos were with (i) less than 20% of fragmentation and (ii) 3–5/4 cells at day 2 or 6–10/8 cells at day 3, respectively.

Results

At day 2, the embryo quality was similar in all groups. However, the mean number of top quality embryos at day 3 was statistically higher into the group 4 (1.4 ± 1.8) compared to the group 1 (0.9 ± 1.0; p = 0.03) and 2 (0.8 ± 1.3; p = 0.05). Furthermore, a significant increase of the mean number of good quality embryos was observed at day 3 into the group 4 (2.6 ± 2.6) compared to the group 1 (1.6 ± 1.6; p = 0.02).

Conclusion(s)

The embryo quality could be modified according to commercial oils used to overlay culture media.