Labial fusion first diagnosed during pregnancy with voiding difficulty and its management: a case report

Introduction: Labial fusion is described as partial or complete adherence of the labia minora. Adhesions of the labia are extremely rare in the reproductive population with only a few cases described in the literature and none reported with pregnancy. Case presentation: A 24-year-old woman who had extensively fused labia with a pinhole opening at the upper midline with menstrual delay was diagnosed at six weeks of pregnancy. The case and its management are presented. Conclusion: The condition was treated surgically with complete resolution of the urinary symptoms

Association of cervical infection of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis with peritoneum colonisation in pregnancy

This study investigated the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis infections in the cervices and peritoneum of pregnant women and compared them with non-pregnant controls. A total of 96 pregnant women who planned to deliver by caesarean section, and 124 non-pregnant women were screened for cervical Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis infections by polymerase chain reaction analysis. If cervical infection was present, peritoneal infection was searched from the Pouch of Douglas during caesarean section in the pregnant group and was searched by culdocentesis in the control group. Chlamydia trachomatis infection was present in 7.3% of pregnant women and 2.4% of the non-pregnant controls. Ureaplasma urealyticum infection was present in 26% of pregnant women and 15.3% of the non-pregnant controls. The incidence of Chlamydia trachomatis and Ureaplasma urealyticum infection was significantly higher in pregnancy. Mycoplasma hominis infection was present less frequently compared with Chlamydia trachomatis and Ureaplasma urealyticum in both groups. Intraperitoneal colonisation by Chlamydia trachomatis was present in only one pregnant woman and in one non-pregnant control. No intraperitoneal infection was detected for Ureaplasma urealyticum and Mycoplasma hominis. Cervical Ureaplasma urealyticum and Chlamydia trachomatis infections were more frequently seen in pregnant Turkish women

Fetal weight estimation and prediction of fetal macrosomia in non-diabetic pregnant women

In the present study we investigated the accuracy of Shepard's formula in the sonographic diagnosis of macrosomic fetus of non-diabetic pregnant women. Three hundred and eighty-one macrosomic and 450 appropriate for gestational age (AGA) fetuses born to non-diabetic mothers between 37-42 weeks of gestation were included in the study. Ultrasonographic fetal weight estimation within two days of delivery was made using Shepard's formula in all patients. The estimated fetal weights were compared with the actual birth weights of the same subjects. We did not observe any macrosomic newborn birth in pregnant women with 3200 g or less fetal weight estimation. However, in patients with 3400-3499 g fetal weight estimation, a statistically significant increase in macrosomic newborn birth was observed. Only 3.2% of newborns having actual birth weights greater than or equal to 4000 g had sonographic birth weight estimation less than 4000 g. Accuracy of weight estimations using the Shepard's formula was found to be low in macrosomic fetus. On the other hand, increased incidence of macrosomic newborn birth was observed in subjects with ultrasonographic fetal weight estimations above 3400 g and this level may be useful as a cut-off value for prediction of macrosomic fetus in non-diabetic pregnant women. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved

FHR MONITORING AND PERINATAL-MORTALITY IN HIGH-RISK PREGNANCIES

The aim of the study was to evaluate the effect of the introduction of fetal heart rate monitoring on perinatal mortality rates in high-risk pregnancies. Results were compared with the perinatal mortality rates published previously from our clinics

Mobiluncus species in gynaecological and obstetric infections: antimicrobial resistance and prevalence in a Turkish population

The purpose of this study was to determine the prevalence and antimicrobial resistance of Mobiluncus species isolated from specimens collected from Turkish women with gynaecological infections. Mobiluncus species were isolated on enriched Schaedler agar and RLK agar plates under anaerobic conditions. The MICs of various antibiotics were evaluated using an agar dilution procedure. The prevalence of Mobiluncus species isolated from vulvo-vaginal abscesses, endometrial smears, salpingitis and bacterial vaginosis was 2%, 4.7%, 3.8% and 49%, respectively. Mobiluncus isolates were only resistant to metronidazole (81% resistance). The isolation rate of M. curtisii was higher than M. mulieris in Turkish women with bacterial vaginosis, vulvo-vaginal abscesses, endometritis or salpingitis. (C) 2005 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved

THE PROGNOSTIC-SIGNIFICANCE OF MATERNAL SERUM-CA125 MEASUREMENT IN THREATENED-ABORTION

The prognostic predictive value of maternal serum CA125 measurement was investigated in 25 cases of threatened abortion. The women were non-smoker, had a ultrasonographically verified viable single fetus, and the gestational ages ranged from 7 to 12 weeks. Twenty-five healthy pregnant women, with the same characteristics were used as the control group. The overall abortion rate was found to be 20% (5/25) in the study group. In serial measurements the mean serum CA125 level of the patients with an unfavorable pregnancy outcome was significantly higher than that of the patients with a favorable outcome. When the cut-off level of maternal serum CA125 was taken as > 65 U/ml in the first and > 60 U/ml in the second measurements of the study group. the risk of termination of the pregnancy by spontaneous abortion was 83.3% in the patients with elevated serum CA125 levels. No statistically significant difference was observed with respect to the duration of vaginal bleeding between the aborters and the patients with a favorable outcome. Nevertheless, when vaginal bleeding had been present for 3 days or more and there was high maternal serum CA125 activity, the abortion risk was found to be 100% (3/3). These findings suggest that the maternal serum CA125 measurement in threatened abortion can be useful to determine the extent of decidual destruction which is directly related to the outcome of pregnancy

Does leukocytospermia associate with poor semen parameters and sperm functions in male infertility? The role of different seminal leukocyte concentrations

To investigate the effect of leukocytospermia on standard semen analysis and sperm function tests such as acrosome reaction, hypoosmotic swelling, antisperm antibody binding and cervical mucus penetration, a prospective clinical study was performed. Two hundred and nineteen male infertility patients undergoing investigation and treatment were included in the study. There was a significant association between acrosome reaction positivity and leukocytospermia according to WHO (World Health Organization) criteria. Increased hypoosmotic swelling test score, higher sperm concentration and enhanced acrosome reaction were closely related to leukocytospermia. When the patients were divided into subgroups according to seminal leukocyte concentrations, acrosome reaction and hypoosmotic swelling were observed to be higher in semen samples with higher leukocyte concentrations compared to those with low seminal leukocyte concentration. In addition, higher sperm concentrations were observed in semen samples with increased leukocyte levels compared to semen samples with low leukocyte levels. These results suggest that leukocytospermia may have a favorable effect on some sperm functions at seminal leukocyte concentrations between 1 and 3 x 10(6)/ml. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved

Sperm selection based on motility in polyvinylpyrrolidone is associated with successful pregnancy and embryo development

The aim of this study was to investigate whether spermatozoon motility in polyvinylpyrrolidone (PVP) is associated with better embryo development and pregnancy rates in ICSI cycles. A total of 123 primary ICSI treatment cycles were included in this study. Semen samples were tested for motility before ICSI procedure in PVP. Within 3min, the presence or absence of motility was recorded. Sperm functions were examined by the aniline blue (AB) chromatin condensation test and the hypoosmotic swelling test, and the chromatin stability was evaluated by inducing its decondensation with sodium dodecyl sulphate and ethylenediaminetetraacetic acid (EDTA). Fertilisation and embryo scoring were evaluated. Fifty (64%) of 78 women conceived in the PVP (+) group; and 12 (26%) of 45 women conceived in the PVP (-) group; the pregnancy rate was significantly higher in the PVP (+) group (P=0.003). Semen parameters were observed to be similar in both groups. The mean number of total embryos obtained in ICSI procedure and transferred grade 1 embryos were significantly higher in PVP (+) group (P=0.01 and P=0.003 respectively). The presence of sperm motility in PVP is associated with increased pregnancy rate, higher percentage of good quality embryos, sperm chromatin condensation and decondensation

THE PREDICTIVE VALUE OF FETAL HEART-RATE MONITORING - A RETROSPECTIVE ANALYSIS OF 2165 HIGH-RISK PREGNANCIES

The predictive value of fetal heart-rate monitoring on fetal well-being was studied in 2165 high-risk pregnancies. 1883 reactive nonstress test (NST) patterns and 278 nonreactive NST patterns and 4 cases of sinusoidal pattern were obtained. Oxytocin challenge test (OCT) was applied to 263 nonreactive cases

Perinatal and maternal outcomes of fetal macrosomia

Objective: To determine the perinatal and maternal outcome of the macrosomic infants. Study Design: A case-control, retrospective study is performed in the Department of Gynecology and Obstetrics, Istanbul University Cerrahpasa Medical Faculty, between 1988-1992. The maternal and neonatal records of infants with birthweight of at least 4000 g (n = 1000) were reviewed. Another 1000 cases amongst the newborns delivered in the same period between 2500 and 3999 g formed the control group. The obstetrical outcome variables of the groups including mode of delivery and the incidence of maternal and perinatal complications were compared. Results: A total of 16,112 deliveries occurred during the study period. The rate of macrosomic deliveries was 6.21% and the rate of the deliveries (4500 g or heavier) was 1.04%. The mean birthweight of the study group was 4272 +/- 239 and 3277 +/- 316 g of the control group (P < 0.001). While the cesarean section rate was 28.8% for the study group and it was 16.6% for the control group (P < 0.001). In the study group, 17 cases of brachial plexus palsy (2.4%), 16 cases of clavicular fracture (2.3%) and one case of humeral fracture were observed (P < 0.001). The rate of perinatal mortality was 0.8%, in the study group. No perinatal mortality was recorded in the control group. There were 14 cases (1.4%)of asphyxia related to delivery in the study group(P < 0.01). The rate of maternal complications, were significantly higher in the study group (P < 0.01). Conclusion: The macrosomic infants are in increased risk for birth trauma and asphyxia. The risk of birth trauma for the infants weighing 4500 g or more is even greater. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved