Infertility is one of the major medical problems nowadays. Couples who opt for In Vitro Fertilization (IVF) face a great deal of stress which certainly affects the outcome of the procedure. ...Therefore, we aimed to reduce the stress during the oocyte retrieval procedure by applying midazolam. Total oxidant (TOC) and antioxidant (TAC) capacities of serum, as well as glutathione (GSH) content and catalase activity, were measured in both control and midazolam groups. Follicular fluid was also tested for oxidant capacity and IL1β. Results implied that the midazolam group increased TAC at the end of the procedure. At the same time, the control group decreased GSH at the beginning of the procedure, and both groups decreased catalase activity at the end of the procedure. The results imply that stress during the procedure affects oxidative and antioxidative parameters of the patients, but did not affect the frequency of the pregnancy at the end of this pilot study. Yet, the results imply that oxidative and antioxidative mechanisms during IVF should be investigated in detail as they could affect the outcome of IVF.
We report a unique case of undetectable serum levels of anti-müllerian hormone (AMH) in women with polycystic ovary syndrome (PCOS) who developed ovarian hyperstimulation syndrome (OHSS) during in ...vitro fertilization (IVF). A case is described of a 28-year-old woman with clinical symptoms of PCOS and AMH serum level below analytical sensitivity (<1.0 pmol/L). After undergoing controlled ovarian stimulation, the patient developed OHSS. After follicle aspiration, seven oocytes were recovered. Three of them were used for intracytoplasmic sperm injection (ICSI) and fertilized, but with unsuccessful pregnancy outcome. A successful pregnancy was achieved in the second IVF/ICSI cycle with six oocytes retrieved and three embryos transferred. At 39 weeks of gestation, the patient delivered a healthy baby weighing 3930 g and 50 cm long. In conclusion, although AMH is considered a useful tool in ovarian reserve assessment and in predicting response to controlled ovarian hyperstimulation, the case presented shows that AMH should not be used as an independent ovarian marker.
A 32-year-old pregnant woman presented to the hospital with abdominal pain and minimal vaginal bleeding. Transvaginal ultrasound revealed visible fluid in pelvic region with suspected tubal rupture, ...and subsequently laparoscopy was performed. During laparoscopy, additional gynecologic pathologies were noticed. Histopathologic finding showed dermoid and endometriotic cyst, as well as tubo-ovarian abscess in the same adnexa. This case report highlights the necessity of considering multiple diagnoses in the same organic system, which may be encountered by surgeon and histopathologist.
•Ectopic implantation in the fallopian tube occurs in up to 98% of all cases.•Abdominal pain needed ultrasound and MRI diagnosis.•Properly developed fetus 19 weeks of gestation in left fallopian ...tube.
Ectopic pregnancy is a medical condition in which a fertilized egg takes an unexpected detour away from the uterine cavity and the fallopian tube becomes a popular host, with the ampulla being the prime location. However, it can occur in other areas such as cervix, ovaries, or abdomen. The most common risk factors are pelvic inflammatory disease, previous pelvic or abdominal surgery, abnormal anatomy of genital organs, endometriosis, previous ectopic pregnancies, assisted reproductive technologies, endocrine disorders, and even the subtle influence of low-dose progestins from contraceptives. We will present a rare case of unrecognized late-stage tubal ectopic pregnancy. The following case report is of a 25-year-old Caucasian female patient (G2, P0) who presented to the emergency department with a 24-hour abdominal pain syndrome. The patient did not have a gynecological examination for this reason. During the examination, taking into account the clinical and ultrasound findings, a suspicion of pregnancy in a bicornuate uterus was raised, and an MRI of the pelvis was performed. MRI showed ectopic pregnancy in the left fallopian tube with a properly developed fetus that corresponded to a gestation of 19 weeks. An emergency laparotomy was performed and the left fallopian tube with the fetus was removed. The early and late course of recovery went smoothly. The patient was discharged after adequate clinical development.
Postmenopausal women have higher risk of cardiovascular disease. One of the contributing factors could be reduced activity of anti-atherogenic enzyme paraoxonase 1 (PON1). The aim of this study was ...to examine differences in the lipid status, paraoxonase and arylesterase PON1 activities and PON1 phenotype in women with regular menstrual cycle and in postmenopausal women.
The study included 51 women in reproductive age (25 in follicular and 26 in luteal phase of the menstrual cycle) and 23 women in postmenopause. Lipid parameters in sera were determined using original reagents and according to manufacturer protocol. PON1 activity in serum was assessed by spectrophotometric method with substrates: paraoxon and phenylacetate. PON1 phenotype was determined by double substrate method.
Compared to the women in follicular and luteal phase, postmenopausal women have significantly higher concentration of triglyceride 0.9 (0.7-1.3), 0.7 (0.6-1.0) vs. 1.5 (0.9-1.7) mmol/L; P = 0.002, cholesterol 5.10 (4.78-6.10), 5.05 (4.70-5.40) vs. 6.30 (5.73-7.23) mmol/L; P < 0.001, LDL 3.00 (2.56-3.63), 3.00 (2.70-3.70) vs. 3.90 (3.23-4.50) mmol/L; P < 0.001, and apolipoprotein B 0.88 (0.75-1.00), 0.79 (0.68-1.00) vs. 1.07 (0.90-1.24) mmol/L; P = 0.002. PON1 basal 104 (66-260), 106 (63-250) vs. 93 (71-165) U/L; P = 0.847 and salt-stimulated paraoxonase activity 210 (131-462), 211 (120-442) vs. 180 (139-296) U/L; P = 0.857 as well as arylesterase activity 74 (63-82), 70 (54-91) vs. 70 (60-81) kU/L; P = 0.906 and PON1 phenotype (P = 0.810) were not different in the study groups.
There are no differences in PON1 activity and PON1 phenotype between women with regular menstrual cycle and postmenopausal women.
Abstract Objectives To compare efficacy, satisfaction and tolerability of oral dydrogesterone and micronized vaginal progesterone gel used for luteal supplementation. Study design Randomized ...controlled trial. A total of 853 infertile women undergoing IVF/ICSI treatment in University Hospital Center “Sisters of Mercy”, Zagreb, Croatia. Luteal support was provided as Crinone 8%® vaginal progesterone gel (90 mg) administered daily, or oral dydrogesterone Duphaston® (2× 10 mg) administered two times daily. Progesterone was administered from the day of oocyte retrieval (day 0) till pregnancy test or in a case of pregnancy, until week 10. Results The on-going pregnancy rates were comparable between Crinone 8%® vaginal progesterone gel and oral dydrogesterone – Duphaston® (28.1% versus 30.3%; OR 1.11 (0.82–1.49 with 95% CI)). Overall satisfaction and tolerability were significantly higher in the dydrogesterone group than in the Crinone group. Vaginal bleeding, interference with coitus and local adverse side effects such as vaginal irritation and discharge occurred significantly more in Crinone group than in dydrogesterone group. Conclusions Oral dydrogesterone is effective drug, well tolerated and accepted among patients and can be considered for routine luteal support. Clinical trial registration number: NCT01178931 ; www.clinicaltrials.gov.
Background
Pregnancy-induced rhinitis (PIR) is a form of chronic non-allergic rhinitis not present before pregnancy that manifests itself during pregnancy with complete resolution of symptoms after ...delivery.
Objective
The objective of this ambidirectional longitudinal cohort study is to evaluate the prevalence of PIR and to investigate the appearance and character of its symptoms, and its impact on the quality of life.
Methodology: Six hundred eighty-one (681) women were recruited in the study. They completed questionnaires about nasal symptoms a day after delivery and each woman with nasal symptoms was interviewed 30 days later and data on symptom duration and quality were recorded.
Results
The prevalence of PIR was 31.86% (N = 217), 47.14% (N = 321) women had no nasal symptoms and 21% (N = 143) of participants had prior sinonasal disease. The clinical presentation of pregnancy rhinitis included nasal obstruction as the most common symptom, followed by rhinorrhea, postnasal secretion, nose itching, sneezing, and hyposmia. The median duration of PIR was 4 months with their complete resolution of symptoms between 2th and 16th day after delivery in the majority of respondents. PIR was diagnosed significantly more often if the women carried a female child. PIR affected their quality of life during pregnancy in 53,9% women (N = 117), with an average VAS score of 8. It seems that pregnancy may affect the course of previously present sinonasal disease (allergic rhinitis, chronic rhinosinusitis, nonallergic rhinitis, or non-infectious rhinitis prior to the pregnancy).
Conclusions
PIR is a common clinical entity with a wide range of symptoms with a direct impact on the quality of life in pregnancy. We propose a new definition of pregnancy-induced rhinitis.
Our study aims to determine the weight gain of pregnant women and their body weight one year after delivery. We compared these changes in body weight with education and place of residence ...(urban/rural).
Secundigravidae women (N = 113) filled out the structured checklist regarding anthropological characteristics, such as body weight (the current and before and after the first pregnancy). Some sociodemographic characteristics were also obtained.
Average weight gain in pregnancy was 16.9 kg (Sd 6.1, median 16 kg; range 6-40 kg). Women with high school education only gained 2 kg more than women with college/university degree (F (1, 108) 4.11, p ≤ 0.05). There was no significant difference in weight gain when the place of residence was compared (F (1, 111) 2.86, p ≥ 0.05). The average weight difference one year after delivery was 3.3 kg (Sd 4.3, median 2 kg; spread -5 to 20 kg). There was no significant difference in weight difference one year after delivery in different educational groups. Women from rural area retained 2.5 kg more than women in an urban area (F (1, 109) 7.50, p ≤ 0.01).
Our research has shown that women with higher education level gain less weight than women with lower degrees. They had more possibility to get access to information about health risks. The overall impression is that women do care about weight gain in pregnancy and actively work on getting back to desirable weight after delivery. This is even more important if we know that body weight before pregnancy, weight gain in pregnancy, pregnancy overweight and pregnancy obesity impact later life of mother and child. Therefore, the need for weight control in pregnancy and between pregnancies should be properly addressed.
The aim of this study was to determine whether ultrasonography itself was able to distinguish benign from malignant lymphadenopathy in patients with thyroid cancer.
We evaluated lymph nodes in a ...group of patients with thyroid cancer. Nodes were detected and measured by ultrasonography, and their shape, echogenicity, size, and location were noted. Ultrasonographically guided fine-needle aspiration biopsy (FNAB) was performed, and smears were analyzed cytologically.
Ultrasonographically guided FNAB was performed in 578 neck nodes in a group of 631 patients with thyroid cancer. In most cases, metastases had a round shape and various echo structures, with a predomination of hypoechoic nodes without a hilum. There were statistical differences in size between metastatic and benign nodes in terms of maximum diameter, minimum diameter, and volume. Among these, minimum diameter and the shape of the nodes seemed to be the most reliable in suggesting malignancy. A round shape with a longitudinal/transverse ratio of less than 2 of hypoechoic nodes indicated the presence of metastases, and we then performed FNAB. The absence of an echogenic hilum and the presence of cystic portions and calcifications were significantly greater in malignancies than in benign lesions (P<.001). In most cases, metastatic nodules were situated in the lower third of the neck. Reactively enlarged nodes occurred more frequently in the upper part of the neck.
Ultrasonography itself cannot distinguish benign from malignant lesions, but an echographic appearance suggests malignancy and helps in the selection of the node to aspirate with ultrasonographically guided FNAB, which is crucial for a final diagnosis.
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