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991.
Matsuura T Takehara Y Kaijima H Teramoto S Kato O 《Journal of assisted reproduction and genetics》2008,25(4):163-167
Purpose Although many reports support stimulated in vitro fertilization, several patients do not respond to it well. Furthermore,
stimulated treatment could be associated with reduced ovarian response. We describe three successful cases involving patients
of advanced age from whom dominant follicles were retrieved during the natural cycle.
Materials and methods All patients had failed to bear children through stimulated in vitro fertilization. In case 1, a follicle was retrieved after
a gonadotropin-releasing hormone agonist was used to induce luteinizing hormone surge. In cases 2 and 3, pregnancy was achieved
via completely natural cycles.
Results One embryo was transferred every 16 cycles. Ongoing pregnancy—defined as pregnancy progressing beyond gestation week 9—was
established in three cycles. The patients successfully delivered and had uneventful neonatal courses.
Conclusion Mature oocyte retrieval followed by natural rather than stimulated in vitro fertilization might be a potential treatment for
patients of advanced age when stimulated in vitro fertilization has been repeatedly unsuccessful.
Capsule We describe three successful pregnancies and deliveries achieved via natural IVF cycles: the patients were older than 37 years
with repeated failures by stimulated IVF. 相似文献
992.
993.
OBJECTIVE: To review the diagnosis and treatment of postoperative femoral motor neuropathy without neurologic consultation or testing. STUDY DESIGN: A retrospective review of 6 consecutive patients with postoperative femoral motor neuropathy following gynecologic surgery. Diagnosis was made on clinical evaluation: history of falling during postoperative ambulation, quadriceps weakness, straight leg raise weakness, diminished knee jerk response, and no evidence of psoas hematoma or abscess. Neurologic consultation, electromyography, nerve conduction study and radiologic imaging, such as computed tomography, were not obtained. Instead, a physical therapy consultation was obtained for a knee orthotic and rehabilitation. RESULTS: Four postoperative femoral motor neuropathies developed following 3,014 cases of major gynecologic surgery (0.1%). Two additional cases were seen in consultation. The median age was 57 years. All patients fell while attempting ambulation on postoperative day 1. Recovery occurred at a median of 3 months (1-4). At a median follow-up of 4 years, no patient had developed additional neurologic sequelae. A history of prior postoperative femoral motor neuropathy was noted in 2 of 6 patients (33%). CONCLUSION: This was the first study of diagnosis and treatment of postoperative femoral motor neuropathy following gynecologic surgery without neurologic consultation or testing. Because of the significant expense of neurologic consultation and testing, patients with postoperative femoral motor neuropathy can have the condition diagnosed by the gynecologist and be referred directly to physical therapy without adversely affecting outcome. This also was the first study to elicit a prior history offemoral neuropathy in 33% of patients. Thus, a prior history may be a risk factor for recurrence. 相似文献
994.
Background Double synchronous primary cancers of gynecological cancers is a common event. However, triple synchronous primary gynecological
cancers is an extremely rare event.
Case A 50-year-old woman, para 0-0-0-0 was admitted to the hospital with a complaint of menorrhagia for 2 months. The preoperative
evaluation and diagnosis was myoma uteri with bilateral ovarian tumor. Subtotal hysterectomy with bilateral salpingo-oophorectomy,
and omentectomy were performed. The postoperative and pathologic findings were adenosquamous carcinoma of the endocervix,
adenocarcinoma of the endometrium, low malignant potential of the right ovary and mucinous cystadenocarcinoma of the left
ovary. She received a complete course of whole pelvic radiation. Unfortunately, she died from pulmonary embolism.
Conclusion The occurrence of triple synchronous gynecological cancers is a rare and unique event deserving further studies 相似文献
995.
Engin-Ustün Y Ustün Y Cetin F Meydanli MM Kafkasli A Sezgin B 《Archives of gynecology and obstetrics》2007,275(6):429-432
Objective The aim of this study was to evaluate the effect of postpartum counseling on postpartum contraceptive use.
Methods One hundred and forty-three women who delivered between 1 January 2004 and 31 September 2004 and counseled about postpartum
contraception were included in the study. The participants were interviewed by telephone. Age, gravidity, parity, and mode
of delivery of the participants were recorded. Their method of contraception before pregnancy, their decision on the contraceptive
method after counseling and the method actually used were asked.
Results Just after postpartum counseling, 47 women (32.9%) decided to use the intrauterine device (IUD), 23 (16.1%) condoms, 16 (11.2%)
progestin injections, 7 (4.9%) oral contraceptives, and 7 (4.9%) coitus interruptus for contraception. Thirty-six women (25.2%)
did not decide on any method of use. At the time of the telephone interview the actual method used was learned. Fifty-one
women (35.7%) were using coitus interruptus, 45 women (31.5%) condoms, and 14 (9.8%) the IUD. Sixteen women (11.2%) were reported
as not using any methods.
Conclusion In spite of postpartum counseling, a high majority of the women appeared to use traditional and less effective contraceptive
methods. 相似文献
996.
Yilmaz B Kelekci S Ertas IE Ozel M Sut N Mollamahmutoglu L Danisman N 《Archives of gynecology and obstetrics》2007,276(5):511-516
Objective The aim of this randomized prospective study was to compare efficacy and side effects of saline moistened misoprostol with
dry misoprostol, administered 800 μg intravaginally every 6 h up to a maximum of 3 doses in 24 h for second trimester pregnancy
termination.
Materials and methods A total of 81 women seeking termination of second trimester pregnancy (55 fetal death, 17 fetal structural anomaly, 5 chromosomal
abnormality, 4 other reasons) were randomly assigned to one of two treatment groups: (1) intravaginal non-moistened (dry)
misoprostol in group A (n = 40) or (2) misoprostol moistened with 3 ml of saline in group B (n = 41).
Results All of the patients in either group aborted within 48 h (100% success rate). Delivery was achieved in a median (interquartile
range) of 13 (40) h with the group A protocol and 12 (36) h with the group B protocol (P = 0.652). Delivery with first dose, delivery within 12 h and delivery within 24 h were similar (P > 0.05) in group B (34.1, 87.5 and 60%, respectively) and group A (25, 82.9, 46.3, respectively). Both treatment regimens were
tolerable and with similar side effects.
Conclusion Misoprostol moistened with saline was not more effective than dry misoprostol for second trimester pregnancy termination. 相似文献
997.
We are reporting a case of ovarian carcinoma, who presented with polymyositis. Polymyositis, without any evidence of dermatomyositis,
as the presentation of ovarian carcinoma has never been reported. In fact, for patients with polymyositis, there does not
appear to be a great increase in the risk of malignancy. The purpose of this report is to make the gynaecologists aware that
polymyositis alone can also be the presenting symptom for ovarian carcinoma. 相似文献
998.
Although debated, most preeminent expert panels recommend routine screening for gestational diabetes mellitus (GDM). Among
the many tests that have been used and evaluated for the screening of GDM, the fasting plasma glucose (FPG) remains very appealing.
It is easy to administer, well tolerated, inexpensive, reproducible and patient friendly. However attractive, the FPG has
given varied results in different populations and its use as a screening test for GDM remains uncertain. This review will
objectively assess the available studies to find the real value of FPG as a screening test for GDM. 相似文献
999.
Objectives We aimed to determine associated ultrasonographic findings, chromosome abnormalities and the prognostic factors of cystic
hygromas in live-born infants.
Methods We reported a series of 57 cystic hygroma cases, who were diagnosed in the first and the second trimester of pregnancy by
means of the ultrasonographic morphology of cystic hygroma, associated structural abnormalities, karyotype analysis and the
autopsy findings. Survivors were followed for their fetal outcome and prognosis.
Results There were 57 new cases of cystic hygroma among 8,155 screenings (0.7%). 35 of the cases (61.4%) were nonseptated and 22 of
the cases (38.6%) were septated cystic hygroma. Chromosomal abnormalities were found in 23 of the cases (40.3%). The most
common abnormality in nonseptated cystic hygroma was trisomy 21 (8 cases, 25%) and in septated cystic hygroma was Turner syndrome
(4 cases, 21.1%). The most common associated structural malformations were cardiac abnormalities (in 7 cases, 20%) in nonseptated
cystic hygroma cases and nonimmune hydrops (in 12 cases, 54.5%) in septated cystic hygroma cases. Overall survival was poor;
only one case of septated cystic hygroma with axillary location and seven cases of nonseptated cystic hygroma, of whom two
died in the neonatal period, were alive (10.5%). This study had 80% power to detect 0.03% difference in diagnosis cystic hygroma
(α = 0.05, β = 0.80).
Conclusion Fetuses with cystic hygroma are at high risk for adverse outcome. Prenatal diagnosis with invasive procedures should be done
in order to inform the parents in detail. Axillary location of the hygroma and the depth of invasion had prognostic importance. 相似文献
1000.
Schmidt P Pruggmayer M Steinborn A Schippert C Staboulidou I Hillemanns P Scharf A 《Archives of gynecology and obstetrics》2007,276(3):259-262
Introduction First-trimester screening according to Nicolaides uses maternal age to obtain a common background risk for trisomy 21. The
likelihood ratios by nuchal translucency, free β-human chorionic gonadotropin and pregnancy-associated plasma protein-A are
not with respect to maternal age. It was the aim of this study to investigate if likelihood ratios should better take care
of it.
Materials Pearson’s correlation and different models of regression analysis had been performed on the results of 8,116 first-trimester
screenings. The total number of pregnancies was subdivided into three subgroups of healthy fetuses (n = 8,038); fetuses with Down’s syndrome (n = 46) and fetuses with other genetic abnormalities (n = 32). Statistical testing was applied to each of the three groups.
Results Strong independence from maternal age could be found for each of the first-trimester screening measurement parameter, as well
for healthy and as for affected fetuses. Neither Pearson’s test nor nonlinear regression models could detect a correlation.
Accordingly significance of Pearson’s test is not given.
Discussion First-trimester screening would not be improved by considering the maternal age in the calculation of the likelihood ratios.
Therefore the currently used algorithm is adequate. According, to the results, it seems to be proper as well to disregard
the maternal age in newer test strategies advanced first-trimester screening (AFS) at all. 相似文献