3 research outputs found
Hydrosalpinx: Tubal surgery or in vitro fertilisation? An everlasting dilemma nowadays; a narrative review
The decision on how to treat tubal diseases, specifically hydrosalpinx, is a difficult one. Ιt involves surgical, medical, social, emotional and economic factors. This narrative review aims to increase awareness of tubal disease diagnosis and treatment, to compare between tubal surgery and in vitro fertilisation (IVF) for tubal factor infertility, and to investigate the effect of the combination of both. This way, we can be more effective, safe and provide our patients with better treatment results. The review analysed randomised studies, trials and meta-analysis, which give new aspects on the treatment methods for tubal pathology before IVF. Recent papers published in English have been studied, alongside guidelines and committee opinions from previous years. Tubal surgery and IVF aim to exploit a woman’s reproductive potential. IVF and endoscopic tubal surgery must be thought of as complementary, rather than competing techniques in tubal disease cases, in order to improve fertility outcome. The first-line treatment for young women less than 35 years old with minor tubal pathology, is tubal surgery. IVF should be offered if there are other factors in a couple’s subfertility, if the patient is >38 years old, if moderate to severe tubal disease is present, and if it has been more than 12 months post-surgery
Seasonal Variation in the Incidence of Severe Preeclampsia in Mediterranean Climatic Conditions
The aim of the study was to evaluate possible involvement of environmental factors in the incidence of preeclampsia. A retrospective observational study on the seasonal variation of severe preeclampsia, derived from the intensive obstetric care unit files over a 48-month period, was undertaken. Obstetrics were studied and all deliveries and number of severe preeclamptic patients were recorded. The extracted data were then divided into four groups, based on the four main seasons of the year. The rates of severe preeclampsia, occurring in each season, were compared. Although there is a trend of higher incidence during summer, statistical difference was not significant (unpaired t -test: p=0.1250 for preeclampsia p=0.1250 for total deliveries, and paired t -test: p=0.0027 for severe preeclampsia p=0.0002 for total deliveries), perhaps due to the small numbers of the studied groups. In this study we found a prevalence of preeclampsia during summer when the weather is warmer than the other seasons. This finding may provide new possible mechanisms in the pathogenesis of preeclampsia
Increased nuchal translucency and diaphragmatic hernia. A case report
Increased nuchal translucency (NT) thickness is present in 40% of fetuses with diaphragmatic hernia, including 80% of those that result in neonatal death and in 20% of the survivors. A 33-year-old nulliparous woman had first trimester scan at 12 weeks. The fetus had a NT of 2.3 mm, normal ductus venosus (DV), and tricuspid doppler and present nasal bone. Pregnancy-associated plasma protein A (PAPP-A) was 0.59 MoM and beta-human chorionic gonadotropin (b-hCG) 2.56 MoM. The couple did not opt for chorionic villous sampling (CVS) and repeat ultrasound examination was advised. At 18 weeks, ultrasound revealed left sided diaphragmatic hernia. The couple consented for termination of the pregnancy. The molecular test showed normal karyotype and male gender. In such cases with intrathoracic herniation of abdominal viscera, the increased NT may be the consequence of venous congestion due to mediastinal compression. The prolonged compression of the lungs causes pulmonary hypoplasia. Increased NT with normal fetal lcaryotype is associated with structural fetal anomalies like diaphragmatic hernia and screening at 16-18 weeks is imperative