Imperforate Hymen Causing Bilateral Hydroureteronephrosis in an Infant with Bicornuate Uterus

A rare case of imperforate hymen associated with bicornuate uterus in an infant is presented as a cause of bilateral hydroureteronephrosis and pelvic mass in infancy. The importance of postoperative radiologic evaluation for diagnosis of accompanying uterine abnormalities is introduced. A 8-month-old girl with restlessness and intermittent fever was brought to the daily outpatient clinic by her parents. Ultrasound exam showed bilateral grade 4 hydroureteronephrosis and a large cystic pelvic mass. Magnetic resonance scan of the pelvis revealed marked hematocolpos. A cruciate incision was made over the hymen under general anesthesia. During a 6-month followup gradual resolution of bilateral hydroureteronephrosis was documented. Although the details of the uterine anomaly were obscured in preoperative imaging, postoperative US and MR demonstrated bicornuate uterus. Postoperative pelvic radiologic examination is highly recommended to verify the resolution of hematocolpos and to screen for any concomitant anomalies that can have long-term clinical significance

Serum and peritoneal fluid levels of ischemia modified albumin in moderate/severe endometriosis

Background: Recently, the role of oxidative stress in progression of endometriosis has been reported. Ischemia-modified albumin (IMA) is a marker of protein oxidation and very limited number of studies has evaluated the role of IMA in endometriosis. This study was designed to evaluate the serum and peritoneal fluid IMA levels in moderate/severe endometriosis as a marker for oxidative stress.Methods: This study was designed as a prospective controlled clinical trial. The study group consisted of 35 cases who underwent laparoscopy and with a diagnosis of moderate/severe endometriosis. The control group (n=35) was cases without endometriosis that underwent laparoscopy for tubal sterilization. The serum and peritoneal fluid IMA levels were measured spectrophotometrically by colorimetric method with complex of albumin non-binding cobalt and dithioerthreitol.Results: Although the median serum IMA levels in study and control groups were similar (p=0.553), the levels of peritoneal fluid IMA were significantly higher in study group (p=0.044). In endometriosis cases with dysmenorrhea peritoneal fluid IMA levels were much higher than cases without dysmenorrhea (p=0.018).Conclusions: The increased levels of IMA in peritoneal fluid of endometriosis support the possible role of oxidative stress in endometriosis. With this study, peritoneal fluid IMA levels are initially documented in endometriosis cases

Controlled ovarian hyperstimulation with sequential letrozole co-treatment in normo/high responders

Objective: To investigate the effect of co-administration of letrozole in an ovarian stimulation protocol using recombinant FSH and GnRH antagonists for ICSI in normo/high responders

Use of diazepam for hyperemesis gravidarum

Objective. To evaluate the efficacy and safety of intravenous (IV) fluid and diazepam therapy compared with the IV-fluid only therapy for the resistant hyperemesis gravidarum (HG) cases. Methods. Medical records of 74 HG cases who were refractory to standard management were reviewed. All patients hospitalised were administered IV fluid and multivitamin combination as the first-step therapy. Patients who were refractory to first-step therapy were given IV fluid (Group 1, n=43) or IV fluid and diazepam (Group 2, n=31) depending on the patients' desire. Groups were matched for demographic characteristics, rehospitalisation requirement, patient satisfaction and neonatal outcomes. Results. Thirteen of the 74 patients were excluded from the study because of unknown maternal and fetal outcome. The mean gestational age was 10.42.4 year. Age, parity, body mass index and educational level were similar between the two groups. Mean diazepam dose was 62.824.5mg (range 40-160) in Group 2 (n=31). The number of hospitalisation was significantly lower, and patient satisfaction was significantly higher in Group 2. There were no differences for the obstetrics outcomes between the groups. Conclusions. The addition of diazepam to IV fluids was associated with less hospitalisation in women with hyperemesis gravidarum. Safety of diazepam therapy in early pregnancy deserves further study