Clinical and experimental obstetrics & gynecology (CLIN EXP OBSTET GYN )

Publisher: Università di Padova. Clinica ostetrica ginecologica


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    Clinical and experimental obstetrics & gynecology, Clinical and experimental obstetrics and gynecology
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Publications in this journal

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    ABSTRACT: To evaluate the effect of sympathomimetic amine therapy for a life threatening autoimmune disorder.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(4):460-1.
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    ABSTRACT: The current study aims to establish reference ranges for thyroid hormones in normal pregnant women during their pregnancy period. A one-time cross-sectional survey was conducted on 490 normal pregnant women and 51 nonpregnant women (control). The serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free tetraiodothyronine (FT4) levels were measured. The serum FT3 and FT4 levels in pregnant women decreased gradually from the first to the last three months of pregnancy (p < 0.01). The serum TSH level increased gradually during the whole pregnancy (p < 0.01), and was significantly lower than the control (p < 0.01) in the first three months. However, in the middle and last three months of pregnancy, TSH was higher than the control (p < 0.01). The thyroid hormone levels in normal pregnant women are different from those in non-pregnant women; significant differences exist among the three stages of pregnancy.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(2):135-40.
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    ABSTRACT: Fetal ovarian cyst is diagnosed at the rate of one per 2,500 live births and its behaviour in utero may range from spontaneous resolution with no further consequences to torsion, necrosis, and to the necessity of surgical treatment in the postnatal stage. Ovarian cyst torsion in a fetus results in the loss of its reproductive function in adult life. The authors present a case of spontaneous resolving fetal ovarian cyst. The lesion was diagnosed during an ultrasound scan in 30th week of pregnancy. An ultrasound scan performed two weeks later revealed symptoms of cyst torsion; the lesion was 5.7 cm in diameter, heterogeneous, and had a normoechogenic inside. A subsequent ultrasound exam showed a lesion with a diameter of 2.16 cm. An ultrasound exam of the newborn's abdominal cavity performed on the second day showed that the cyst was six mm in diameter. However, the cyst did not show on an ultrasound scan made on the fourth day.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(1):78-9.
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    ABSTRACT: Prevalence ofanencephaly in dichorionic twins is higher than in singleton pregnancies. The authors report two cases with two different management strategies. Spontaneous dichorionic diamniotic twin pregnancy with the second twin diagnosed with anencephaly at 12 weeks gestation. Selective feticide was performed at the age of 13.2 weeks. Vaginal delivery occurred at 39 weeks, and birth weight was 2,850 g. Dichorionic diamniotic twin pregnancy discordant for anencephaly in the second twin was diagnosed at 13 weeks gestation. An expectant management was decided. Preterm delivery occurred at 35 weeks due to hydramnios of the affected fetus, delivering a healthy newborn weighing 2,300 g and an anencephalic neonate who died immediately after delivery. Anencephaly should be diagnosed as soon as possible, idealistically at 11-13+6 weeks ultrasound (US) scan, in order to offer the most appropriate counselling to the parents, ranging from selective feticide or expectant management. This short series suggests that selective early feticide may increase gestational age and birth weight.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(2):208-10.
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    ABSTRACT: This study was undertaken to evaluate the effects of magnesium sulfate (MgSO4) on the contractile activity of the uterus in a pregnant rat model of preeclampsia induced by N-nitro-arginine methyl ester (L-NAME). Twenty-eight, 160-220 gram, three to four month old female Sprague-Dawley rats were used in this study. After conception was confirmed by vaginal smears on the first day of pregnancy, the animals were allocated into four groups according to the chemicals fed in their drinking water as control (nothing administered), L-NAME (50 mg/kg L-NAME), MgSO4 (600 mg/kg MgSO4), and MgSO4 + L-NAME group (600 mg/kg MgSO4 + 50 mg/kg L-NAME). The pregnant uterus strips were isolated on the 19th day and the contractile activity of uterus was examined by applying 0, 0.1, 0.2, 0.4, 0.8, and 2.5 mIU/ml oxytocin to each group and responses are recorded accordingly. There were no statistically significant differences regarding fetal parameters and peak amplitudes of the oxytocin stimulated pregnant rat myometrial strips among groups. In L-NAME group at 0 and 0.1 mIU/ml oxytocin, the contraction frequency in a ten-min period was statistically lower than the control group (Z = -2.850, p = 0.004; Z = -2.902, p = 0.004, respectively). In MgSO4 group only at 0 mIU/ml oxytocin, the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = -2.973,p = 0.003). In L-NAME + MgSO4 group at 0, 0.1 and 0.2 mIU/ml oxytocin concentrations the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = - 4.018, p = 0.000; Z = -3.237, p = 0.001; Z = -2.902, p = 0.004, respectively). In L-NAME + MgSO4 given group at each oxytocin concentrations, the frequencies of the contractions in ten-min period were lower but not statistically different than the L-NAME group. MgSO4 has no significant effect on the amplitude of spontaneous or oxytocin induced myometrial contractions, but decreased the frequency of spontaneous contractions. At each doses of oxytocin, MgSO4 has no significant effect on the frequency of contraction in a pregnant rat model of preeclampsia induced by L-NAME.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(2):169-73.
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    ABSTRACT: Agenesis of the corpus callosum is an uncommon cerebral malformation usually of unknown etiology. It can be associated with other brain abnormalities, such as ventriculomegaly, or in combination with problems with other organs, such as congenital heart defect, as well as with chromosome anomalies. Diagnosis of this rare anomaly is important not only because of possible association with other developmental anomalies but also because of postnatal treatment and evaluation of children with this disorder. This paper presents prenatal diagnosis of partial agenesis of the posterior part of corpus callosum of a fetus detected in gestational week 33 by ultrasonography as an isolated developmental disorder, i.e., not accompanied by other morphological anomalies of the fetus or chromosome aberrations or other genetic defects.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(2):233-5.
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    ABSTRACT: The aim of this study was to compare the success of surgical procedures performed by laparoscopy and laparotomy in the treatment of tubal ectopic pregnancy.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(3):276-9.
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    ABSTRACT: The current study explored the impact of gestational weight gain on postnatal pelvic muscle strength and the effect of low-frequency electrical stimulation combined with biofeedback training on strength recovery.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(4):399-401.
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    ABSTRACT: The authors report a case of a 61-year-old woman diagnosed with large bladder diverticulum. Diagnosis was performed only after a series of investigations carried out for the occasional finding of hypercreatininaemia. Although the significant volumes of post void residual (PVR) and the relevant urine stagnation in the diverticulum, subjective symptomatology was absent and urinalysis and urine culture were negative. The scheduled therapeutic plan consisted of fosfomycin three grams every ten days for sixmonths, self-catheterization twice a day, voiding on a time schedule, and adequate fluid intake. The monthly scheduled follow-up at one year showed good general health, good compliance with the therapy, no urinary tract infections, a decrease in creatininemia to 1.2 mg/dl, and regression of nephrohydrosis to a mild stage. In conclusion, the absence of symptoms and negative urinalysis or urine culture allows expectant management despite the considerable size of the bladder diverticulum.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(1):87-9.
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    ABSTRACT: The authors here report a case of an infertile woman with diffuse leiomyomatosis of the uterus, which is a rare benign pathological condition in which the myometrium is occupied by innumerable small fibroid nodules. Due to the progressive abdominal distension of the patient and the desire for pregnancy of the couple, myomectomy was performed as a primary treatment. Urgent relaparotomy was required for hematoma debridement on the following day. Despite the evidence of the follicular growth and cyclic ovarian steroid secretion, the patient had postoperative endometrial thinning that was unresponsive to hormone replacement therapy. Supplementation of oral tocopherol nicotinate/vitamin E and ascorbic acid/vitamin C was effective for immediate recovery of withdrawal bleeding and gradual gain of endometrial thickness. The patient had a successful pregnancy in an in vitro fertilization-embryo transfer program and gave a birth to a healthy baby.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(3):357-9.
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    ABSTRACT: Endometriotic foci can be rarely found on the surgical incision following caesarean delivery and on perineotomy site following vaginal delivery.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(3):360-1.
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    ABSTRACT: To evaluate the effect of the premedication with dehydroepiandrosterone (DHEA) on the results of the in vitro fertilization (IVF) treatments in a group of women with evidence of diminished ovarian reserve. This experimental, prospective, pre-post study enrolled 29 patients with evidence of diminished ovarian reserve and poor-responders to a previous treatment. They received 75 mg/die of DHEA for a minimum of eight weeks; from the 18th day of the cycle before the stimulation with follicle stimulating hormone (FSH), they took trans-dermal estradiol (E2) (50 mcg every other day). The protocol of the stimulation consisted of a short cycle with follicle stimulating hormone receptor-human menopausal gonadrotropin (FSHr-HMG) and low doses ofgonadotropin releasing hormone agonist (GnRH-a) (0.05 mg/die). The study was carried out comparing the results obtained respectively with the pre-DHEA and the post-DHEA treatments. The comparative analysis of the results showed a significant increase in the number of the retrieved oocytes (p < 0.01), of the oocyte quality (p = 0.02) and a reduction of cancelled cycles (p = 0.03). Moreover, after the treatment with DHEA, there was an increase, though non-significant, in the number of embryos, in the fertilization rate, and in the number of pregnancies. This study confirms the beneficial effects of DHEA in patients who resulted poor responders to IVF treatments. Therefore, DHEA appears to be an effective treatment for age related sub-fertility.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(1):5-9.
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    ABSTRACT: A 36-year-old woman, gravida 5, para 3, was referred to this outpatient clinic in the 18th week of gestation for monitoring of her pregnancy. A 22-week anomaly scan confirmed hypoplastic left heart syndrome (HLHS) but the parents declined any medical intervention. Here the authors present the management of a pregnancy and the expected quality of neonatal life.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(1):100-1.
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    ABSTRACT: The purpose of this study was to evaluate the relationship between fetal karyotype and parental chromosomal abnormalities, and assess the long-term reproductive outcomes in couples with recurrent miscarriages (RM).
    Clinical and experimental obstetrics & gynecology 01/2014; 41(3):249-53.
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    ABSTRACT: The synchronization of the uterus and mature eggs at the molecular level is the key factor in embryo transfer, and the regulation of synchronization depends on a variety of cytokines. C-reactive protein (CRP), as the first acute phase reaction protein, is involved in the entire process of embryo transfer. The study is designed to investigate the correlation among CRP, sex hormone, controlled ovarian hyperstimulation (COH) cycle, and pregnancy outcome. Ninety-two patients who accepted in vitro fertilization (IVF) treatment cycles because of tubal factor were included in the study. Seventy treated cases were included to complete final analysis with the full set of results. Respectively on the second day of the menstruation (Day-2) in gonadotropin-releasing hormone agonist (GnRH-a) short program treatment, on the morning in human chorionic gonadotropin (hCG) treatment (Day-hCG) and the embryo transplant day (Day-ET), plasma CRP level was tested by enzyme-linked immunosorbent assay (ELISA). The correlativity among CRP level, sex hormone, COH, and pregnancy outcome was analyzed by statistical methods. In the short program GnRH-a of 70 cases, there was no relationship between serum CRP level and the infertility age, gonadotropin (Gn) dosage, number of oocytes retrieved, the number of normal fertilization, and sex hormone. In the short program of GnRH-a, the change of serum CRP levels in Day-2, Day-hCG, Day-ET: serum CRP in Day-2 < Day-hCG < Day-ET and the level of serum CRP gradually increased in Day-2, Day-hCG, and Day-ET in both the pregnant group and non-pregnant group. In non-pregnant group, the ratio of hCG/D2 and ET/hCG-day were significantly higher than the pregnant group. The area under receiver operating characteristic (ROC) curve was 0.806, indicating the accuracy of diagnostic tests is medium, the authors chose the point which presents the ratio of CRP in Day-ET to Day-hCG which was less than 1.752 as a predictor of treatment outcome, the sensitivity of the experiment was 77.8%, and the specificity 75%. CRP as a sensitive inflammatory marker, CRP ratio of Day-ET/Day-hCG could be a predictor of treatment outcome by ROC curve analysis in COH program.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(2):190-4.
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    ABSTRACT: This study aims to determine the difference between transcervical resection of septum (TCRS) and transcervical incision of septum (TCIS) in the improvement of reproductive prognosis. Women with uterine septum in the Affiliated Hospital of Ningxia Medical University were retrospectively analyzed. A statistical method was used according to operative time, postoperative menstruation, postoperative pregnancy rate, postoperative term delivery rate, and so on. Compared with TCRS, the TCIS method decreased operative time, blood loss, and consumption of uterus distension medium. No statistical difference was observed in operative complications between the two methods. After TCIS, the incidence of uterine adhesion was low and the degree of endometrial epithelialisation was high by hysteroscopy review. No statistical difference was observed in residual septum after the operation. The total pregnancy rate after TCIS was higher than that of TCRS. However, no statistical difference was observed in early and late pregnancy loss rates, preterm birth rate, and term birth rate. TCIS exhibits advantages of decreasing operative time, blood loss, and consumption of uterus distension medium. TCIS can reduce the incidence of uterine adhesion and can promote endometrial epithelialisation, which are the key factors to increase pregnancy rate after operation.
    Clinical and experimental obstetrics & gynecology 01/2014; 41(1):20-3.