Comparison of two different antibiotic regimens for the prophylaxisis of cases with preterm premature rupture of membranes: a randomized clinical trial

Objectives: The aim of the study was to assess the effect of 1 g ampicillin prophylactic dosage whether it is as effective as the dosage of 2 g to prevent maternal and neonatal morbidity in a randomized manner. Materials and methods: One hundred and fourty eight singleton pregnant women with preterm premature rupture of membranes between 21 and 33 weeks of gestation were followed-up during the study period in our institution. We com­pared the efficacy of two different different dosages of ampicillin. The study population was randomized into 2 groups. In the group 1, 1 g of intravenous ampicillin was given every 6 hours. In the group 2, 2 g of intravenous ampicillin was given every 6 hours. Results: There was no significant difference between groups interms of fetal complications (RDS, icterus, mortality, sepsis, transient tachypnea of newborn and the pneumonia), rate of intensive care unit admission, fetal gender, fever, rate of clinical chorioamnionitis, high white blood cell count and the CRP, rate of cases < 30 weeks (p > 0.05). There was a significant differ­ence between the groups for the rate of previous preterm premature rupture of membranes history, steroid administration and the need for tocolysis (p < 0.05). Conclusions: Although antibiotics seems to be innocent, several side effects have been introduced. It is reasonable to use the lowest dosages in shortest period in order to minimize these unwanted effects

Giant leiomyosarcoma: A case report

INTRODUCTION: Uterine leiomyosarcoma is a rare uterine malignancy. Most of the patients lack symptoms or present with a rapidly enlarging pelvic mass

Shorter the cervix, more difficult the placenta percreta operations

Background: To determine the impact of cervical length (CL) on the clinical outcome of patients undergoing peripartum hysterectomy due to placenta previa/percreta

Comparison of the Effect of Laparoscopic and Abdominal Hysterectomy on Lower Urinary Tract Function, Vaginal Length, and Dyspareunia: A Randomized Clinical Trial

Objectives: The effect of hysterectomy on vesicourethral and sexual functions remains controversial. The primary objective of this study was to compare the effects of a laparoscopic hysterectomy and a total abdominal hysterectomy on lower urinary tract function. The secondary aims were to compare the two surgeries in terms of postoperative vaginal length and dyspareunia. Materials and Methods: This was a prospective randomized clinical study in which 292 women were assigned to either the laparoscopic hysterectomy (n=146) or total abdominal hysterectomy (n=146) groups. The vaginal length and urodynamic measurements were taken, and the patients were asked to grade the presence and severity of dyspareunia using a visual analog scale 3 weeks before and 12 weeks after the surgery. The relationship between the postoperative vaginal length and the incidence of dyspareunia was evaluated. The urodynamic procedures used included uroflowmetry and voiding cystometry to record the maximum flow rate (Q-max) and to assess the bladder capacity. Results: The preoperative vaginal length was similar between the groups, whereas the postoperative vaginal length was significantly longer in the laparoscopic hysterectomy group. When the 15 patients who developed postoperative dyspareunia were evaluated, no differences in the postoperative vaginal length were seen, but a significant difference in the change in the length of the vagina was found when compared with the other patients. No significant difference was found with regard to pre- and postoperative Q-max, bladder capacity, and change in bladder capacity between the study groups. Conclusions: The change in the length of the vagina was much more remarkable after total abdominal hysterectomy, compared with laparoscopic hysterectomy. It seems that the Q-max and the bladder capacity increase after hysterectomies, regardless of the surgical type. Further prospective randomized comparative studies are warranted to ascertain whether laparoscopic hysterectomies cause less damage to the pelvic floor, compared with abdominal hysterectomies

Coagulation tests at trigger day in patients with Factor V Leiden Mutation to predict implantation failure

Objectives: The aim of this study was to assess the predictive value of coagulation tests at trigger day in patients with isolated factor V Leiden mutation who underwent intracytoplasmic sperm injection cycle (ICSI). Study Design:  Ninety women with isolated factor V Leiden mutation underwent ICSI cycles with an indication of unexplained infertility. In all participants antagonist protocol was used for ovarian hyperstimulation and coagulation tests including activated partial thromboplastin time (APTT), partial thromboplastin time (PT), international normalized ratio (INR), serum fibrinogen and D-dimer levels at trigger day were determined to predict successful implantation. All the clinical parameters specific for the treatment and some patient characteristics were recorded for each participants. Results: There was no significant difference between groups with and without succesfull implantation in terms of age, body mass index, basal hormone levels (follicle stimulating hormone, estradiol, progesterone at day 3 and antimullerian hormone) (P > 0.05). Estradiol and progestrone levels at trigger day were comparable between groups  (P > 0.05). Groups had similar endometrial thickness at embryo transfer day (P > 0.05). Some ovarian stimulation characteristics including initial gonadotropin dose, number of follicles > 17 mm, number of oocytes harvested and number of embryos were similar between groups (P > 0.05). Although there was no significant difference between groups with regard to APTT and PT levels, INR level were significantly lower while D-dimer levels and fibrinogen were significantly higher in cases without implantation (P < 0.05). Conclusion: D-dimer, fibrinogen and INR levels were significant predictors for successful implantation in women with isolated factor V Leiden who underwent ovulation hyperstimulation