Prenatal ultrasonographic findings of adhesion-membrane complex and its relation with obstetric history

Background: Intrauterine adhesions are usually detected incidentally during routine obstetric ultrasound and remain one of the reasons for concern for both clinicians and patients. Objective: Our objective was to document ultrasonographic findings of intrauterine adhesions detected in obstetric ultrasound and to investigate their correlation with obstetric history. Study Design: Detailed scans were performed in 685 singleton pregnancies at 16-24 weeks' gestation. Intrauterine adhesion was referred to as "adhesion-membrane complex'' (AMC). Patients were divided into three groups: Group I consisted of patients with >= 1 therapeutic D&C associated with pregnancy but with neither vaginal delivery nor Cesarean section (CS). Group II consisted of patients with >= 1 CS but with neither vaginal delivery nor therapeutic D&C associated with pregnancy. Group III consisted of patients who were in their first pregnancy. Ultrasonographic properties of AMC and relationship between AMCs and obstetric history were investigated. Results: The incidence of AMC in Group I (n = 108), Group II (n = 189), and Group III (n = 388) was 11.1% (n = 12), 1.05% (n = 2) and 1.03% (n = 4), respectively. Positive history of D&C is associated with significantly increased risk of AMC (risk ratio:10.778; 95% confidence interval: 3.55-32.75). Also, previous history of CS is not associated with significantly increased risk of AMC (risk ratio: 1.026; 95% confidence interval: 0.19-5.55). The AMCs were located in the upper half in 7 (38,9%) and in the lower half of the uterus in 11 (61.1%) patients. The midpoint thickness of the AMC was between 0.75 and 5.10 mm (mean: 2.65 mm; SD +/- 1.2). The width of the AMC was between 2 and 52 mm (mean: 20.98; SD +/- 15.3), the heights of the AMCs were 5-60 mm (mean: 33.27 mm; SD +/- 17.0). In ten of the AMC positive patients (55.6%) a thick and bulbous free end and in eleven of them (61.1%) a "Y image" was detected. The mean gestational age at birth was 37.4 (SD +/- 3.3) weeks in 18 patients with AMC. There were no intrauterine fetal or perinatal deaths. None of the neonates had congenital abnormalities. Conclusions: Intrauterine adhesions detected in obstetric ultrasonography were redefined and renamed in a more comprehensible manner. Our results pointed out that while the positive history of D&C is associated with significantly increased risk of AMC, previous history of CS is not associated with significantly increased risk of AMC

Doğurgan çağdaki kadınlarda istemli düşüklerin boyutları

In recent years, there has been significant growth in the use of computer networks to support electronic delivery of information. As the volume of available information has grown, a need for powerful tools that can manage access has arisen. It has been suggested that hypertext techniques can provide such a facility. The Microcosm system is a hypertext link service developed at the University of Southampton. The system is based upon a modular architecture which allows the functionality of the system to be easily and dynamically extended. This paper describes the development of a distributed version of Microcosm based upon this modular design. The distributed system described utilises the fine granularity of the Microcosm model to support a wide range of possible configurations. The system also extends the document management facilities of Microcosm to allow information stored by other information services to be incorporated. The result is a system that can apply Microcosm's open linki..

Cleft Lip With or Without Cleft Palate: Prenatal Diagnosis, Chromosomal Abnormalities, Associated Anomalies and Postnatal Outcome in 18 Fetuses

OBJECTIVE: The aim of this study was to present our experience with prenatal diagnosis of cleft lip and/or palate (CL/P) and to determine the relationship between facial clefts, associated malformations and chromosomal anomalies. STUDY DESIGN: Data of 18 fetuses with prenatally diagnosed CL/P were retrospectively analyzed. Postnatal outcome and incidence of additional malformations and chromosomal abnormalities were determined. RESULTS: Postnatal findings confirmed that the type of cleft was median CL+P (n=3), bilateral CL+P (n=5), unilateral CL+P (n=5), unilateral CL (n=5). Eight cases were diagnosed at or before 24 weeks of gestation. Eleven fetuses (%61) had additional structural anomalies. Abnormal fetal karyotype was present in 5 fetuses (two cases with trisomy 13 and three cases with trisomy 18). All fetuses with isolated CL/P survived after surgery. Termination of pregnancy was requested in nine fetuses with additional anomalies and/or chromosomal anomalies, whereas one each of the fetuses died in utero or early neonatal period. CONCLUSION: In pregnancies complicated with CL/P, patients should be informed about the risk of associated anomalies, chromosomal abnormalities and syndromic conditions

Isolated torsion of the fallopian tube during pregnancy - A case report

BACKGROUND: Isolated fallopian tube torsion during pregnancy is a rare condition, and only 16 cases have been reported. In all but 1 case the right tube was affected. We report the second case of isolated left fallopian tube torsion during pregnancy

Comparison of two oral contraceptives containing either drospirenone or cyproterone acetate in the treatment of hirsutism

Combined oral contraceptives (COCs) are considered the first-line treatment for women with hirsutism. They diminish androgen release from the ovary and decrease plasma free testosterone levels by increasing sex hormone-binding globulin (SHBG) concentrations. COCs containing cyproterone acetate (CPA) and drospirenone (DRSP) have been proved effective for the treatment of acne and facial hirsutism. This study prospectively compared the clinical and biochemical efficacy of 3 mg DRSP/30 mu g ethinyl estradiol (EE) and 2 mg CPA/35 mu g EE combinations in a total of 91 patients with hirsutism. Individuals randomly received a cyclic combination of either DRSP/EE (n = 48) or CPA/EE (n = 43) for 12 months. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate and SHBG levels, as well as Ferriman-Gallwey scores, were determined before and after treatment. Both COCs achieved a similar effect on clinical hirsutism scores, in addition to serum androgen and SHBG levels, after completion of therapy. The percentage reductions in total hirsutism score (median % (min-max)) during therapy were 0.70 (0-0.58) vs. 0.57 (0.10-1.00) at 6 months (P = 0.028) and 0.80 (0-0.42) vs. 0.81 (0-0.75) at 12 months (p = 0.6) in the DRSP/EE and CPA/EE groups, respectively. In conclusion, the DRSP/EE combination is at least as effective as the CPA/EE combination in improving hirsutism scores

Isolated torsion of fallopian tube in a post-menopausal patient: A case report

Isolated fallopian tube torsion after menopause is a rare condition. Here we report the second case of isolated fallopian tube torsion in a post-menopausal woman. A 55-year-old post-menopausal woman presented with right lower abdominal pain. Sonography depicted a simple cystic mass adjacent to the right uterine border. Laparatomy revealed torsion of the right fallopian tube together with a paraovarian cyst. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed. Histopathological examination revealed a simple paraovarian cyst with severe congestion, necrosis and hemorrhage. Tubal torsion Should be considered in the differential diagnosis of acute lower abdominal pain, even in post-menopausal women. (c) 2007 Elsevier Ireland Ltd. All rights reserved

Sildenafil reduces postoperative adhesion formation in a rat uterine horn model

Objective: The purpose of this experimental study was to evaluate the effect of oral sildenafil on postoperative adhesion formation in rats. Study design: Thirty-two Wistar Albino rats were subjected to standardized lesion by cauterization of the uterine horn and abrasion of the adjacent parietal peritoneum. They were randomized to receive sildenafil at a daily dose of 15 mg/kg, 7.5 mg/kg and 3.75 mg/kg or placebo. Sildenafil was administered by gavage I h before the operation and daily for 5 days after the procedure. The extent and severity of adhesions were assessed on the 14th postoperative day.ObjectiveThe purpose of this experimental study was to evaluate the effect of oral sildenafil on postoperative adhesion formation in rats.Study designThirty-two Wistar Albino rats were subjected to standardized lesion by cauterization of the uterine horn and abrasion of the adjacent parietal peritoneum. They were randomized to receive sildenafil at a daily dose of 15&nbsp;mg/kg, 7.5&nbsp;mg/kg and 3.75&nbsp;mg/kg or placebo. Sildenafil was administered by gavage 1&nbsp;h before the operation and daily for 5 days after the procedure. The extent and severity of adhesions were assessed on the 14th postoperative day.Result(s)The severity but not extent of adhesions in rats given 15&nbsp;mg/kg sildenafil was significantly less when compared with the other groups (&lt;0.001).ConclusionSildenafil diminishes peritoneal adhesion formation in rat.</p