European journal of obstetrics, gynecology, and reproductive biology

Publisher: Elsevier

Description

  • Impact factor
    1.97
  • 5-year impact
    0.00
  • Cited half-life
    7.00
  • Immediacy index
    0.18
  • Eigenfactor
    0.01
  • Article influence
    0.48
  • ISSN
    1872-7654

Publisher details

Elsevier

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, arXiv.org or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To investigate the effect of bladder distention before outpatient hysteroscopy (OH). Study design Initially, 120 eligible patients were approached, and a total of 102 patients were recruited into the randomised controlled trial. OH was completed successfully in 97 patients. Pain scoring (visual analogue scale) and the ease of cervical entry (Likert scale) were the primary outcome measures. The secondary outcome measures in this study were the duration of the procedure and patient acceptability (Likert scale). Result(s) Bladder distention before OH was related to easier cervical entry, a shorter procedural time and low pain scoring in patients who underwent the procedure with a full bladder. Conclusion(s) Bladder distention before OH significantly improved the pain score of patients and increases the feasibility of the hysteroscopy procedure.
    European journal of obstetrics, gynecology, and reproductive biology 09/2014; 180:89–92.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To report basic measurements of clitoral anatomy, and explore potential relationships between the clitoral complex and female sexual function using MRI assessment. Study design: In this retrospective descriptive study, 20 sexually active women (≥ 18 years) who had a recent pelvic MRI for various gynecologic concerns were invited to participate. Outcome measures included demographic data, medical and sexual history, quality of life questionnaires: Female Sexual Function Index (FSFI), Body Exposure during Sexual Activities Questionnaire (BESAQ), and Short Form Quality of Life Questionnaire (SF-12). These data were then compared to detailed clitoral MRI measurements and analyzed using the Pearson correlation and Chi square test. Results FSFI domains of desire, arousal, lubrication, and orgasm were inversely correlated with clitoral size (p = 0.01-0.04), as were SF-12 physical composite scores (p = 0.003), suggesting improved sexual function and physical health in women with smaller clitoral structures (specifically the clitoral body and crus). Conclusion Sexual function was improved in women with a smaller-sized clitoris, specifically the clitoral body and crus.
    European journal of obstetrics, gynecology, and reproductive biology 09/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Glassy cell carcinoma (GCC) is a histologically aggressive subtype of cervical cancer with rapid growth and early metastases. The prognosis for patients with GCC is poor. This article reviews the literature pertinent to the epidemiology, cytology, pathology, immunohistochemistry, treatment and prognosis of GCC. MEDLINE (PubMed) was searched for all articles or abstracts on patients diagnosed with GCC published (in English) since the original definition by Glucksmann and Cherry in 1956. Accurate diagnosis of GCC enables implementation of the correct treatment strategy. Early-stage GCC should be treated with hysterectomy and pelvic lymph node dissection, with adjuvant radiochemotherapy if at least one intermediate or high risk factor for cervical cancer is present. Advanced GCC should be treated with neoadjuvant radiochemotherapy or chemotherapy with the aim of making the disease operable. There is a need for retrospective evaluation of GCC treatment from several centres to explore knowledge about this rare entity. Future studies should explore the role of targeted therapies and the most efficient chemotherapy regimen for the management of GCC.
    European journal of obstetrics, gynecology, and reproductive biology 08/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To establish a new mouse model for autoimmune-type recurrent spontaneous abortion (AI-RSA) and demonstrate the potential role of intrauterine immunization with β2GP-1-like antigen in AI-RSA, we performed an intrauterine injection of human β2GP-1 in BALB/c mice and unrelated protein, adjuvants, and normal saline (NS) as controls. The mean number of embryos implanted (MNEI), embryo loss rate (ELR), mean embryo bulk (MEB), and mean placental weight (MPW) were analyzed. Compared with the control mice, BALB/c mice injected with human β2GP-1 showed increased anti-β2GP-1 and MPW. Moreover, BALB/c mice immunized with human β2GP-1 exhibited hypercoagulability and vascular thrombus formation in the placenta. Electron microscopy confirmed the existence of platelet aggregation, mitochondrial swelling, and endothelial cell necrosis in the placentas of BALB/c mice immunized with human β2GP-1. These finding indicated that intrauterine immunization with β2GP-1 successfully induced AI-RSA in mice. Increased anti-β2GP-1 antibody could independently induce hypercoagulability, vascular endothelial injury, and vascular thrombus formation in the placenta, which led to AI-RSA.
    European journal of obstetrics, gynecology, and reproductive biology 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Thoracic endometriosis is a relatively rare type of endometriosis and includes catamenial pneumothorax, hemothorax and hemoptysis, and presence of intrathoracic endometriotic nodules. We want to clarify and resume the most appropriate management of this pathology. Study design We retrospectively reviewed all the cases of thoracic endometriosis diagnosed and followed up in our Unit from 2005 to 2013. This search revealed five women, with a mean age of 34.5 (26–44). Four had previous history of endometriosis or severe dysmenorrhea. One patient complained of chronic shoulder pain with diaphragmatic implants, another one presented catamenial hemoptysis, and three women suffered from catamenial pneumothorax, with right-side preference. Results Three patients underwent surgery and all of them were treated with GnRH agonists at least during 6 month referring improvement in symptoms. After 1–8 years follow-up, all these patients remain asymptomatic. Conclusion The optimal management of thoracic endometriosis needs further evaluation but the combined approach by hormonal therapy and surgery could be the best option.
    European journal of obstetrics, gynecology, and reproductive biology 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To determine whether intracytoplasmic sperm injection (ICSI) could prevent total fertilization failure (TFF) and enhance the embryo quality in patients with non-male factor infertility. Study Design Two hundred and ninety-six in vitro fertilization (IVF) cycles performed in patients with non-male factor infertility between April 2009 and March 2013 were included in this retrospective study. During the period, ICSI and conventional IVF were performed in 142 and 154 cycles, respectively. The usual indications for ICSI were in the cycles of patients with 1) known low fertilization rate, 2) repetitive implantation failure, 3) advanced maternal age, 4) presence of endometrioma, 5) low oocyte yield (number of oocytes ≤3), or 6) poor quality oocytes. The rate of TFF, normal fertilization, abnormal pronuclei (PN) formation, embryo quality, and pregnancy outcomes between the patients treated with ICSI and conventional IVF cycles were compared. Results The patients treated with ICSI (ICSI group, n = 142) presented fewer number of oocytes than patients treated with conventional IVF cycles (n = 154). The TFF rate was not different (4.2% vs. 0.6%, P = 0.059), but the ICSI group presented a significantly higher rate of normal fertilization (83.4% vs. 79.1%, P = 0.04) and lower rate of abnormal PN formation (3.9% vs. 13.3%, P < 0.01). The cleavage stage embryo quality was better in the ICSI group (grade A: 31.1% vs. 21.3%, P = 0.001; grade A + B: 65.1% vs. 47.6%, P < 0.001). Conclusion The result of this study does not support the use of ICSI to prevent TFF in patients with non-male factor infertility. However, ICSI improved the fertilization rate and the embryo quality.
    European journal of obstetrics, gynecology, and reproductive biology 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To show whether a clinically significant difference in success rates exists between expectant and surgical management of early pregnancy loss. Study design Randomized controlled trial comparing expectant versus surgical management of early pregnancy loss over a one-year period from 1st January to 31st December 2009 at Sultanah Aminah Hospital, Johor Bahru. Pregnant women with missed or incomplete miscarriages at gestations up to14 weeks were recruited in this study. The success rate in the surgical group was measured as curettage performed without any complications during or after the procedure, while the success rate in the expectant group was defined as complete spontaneous expulsion of products of conception within 6 weeks without any complication. Results A total of 360 women were recruited and randomized to expectant or surgical management, with 180 women in each group. There was no statistically significant difference in the success rate between the groups and between the different types of miscarriage. With expectant management, 131 (74%) patients had a complete spontaneous expulsion of products of conception, of whom 106 (83%) women miscarried within 7 days. However, the rates of unplanned admissions (18.1%) and unplanned surgical evacuations (17.5%) in the expectant group were significantly higher than the rates (7.4% and 8% respectively) in the surgical group. The complications in both groups were similar.
    European journal of obstetrics, gynecology, and reproductive biology 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The recent characterization of possible stem/progenitor cells in the endometrium has shed new light on the origins of ectopic endometrial tissue and the mechanism for the pathogenesis of endometriosis, but has raised new questions. Is it possible that abnormal endometrial stem/progenitor cells increase their capacity to implant and establish themselves as ectopic tissue, or that normal stem cells implant in abnormal peritoneum? This study investigated key stem cell properties in cologenic epithelial and stromal cells obtained from eutopic endometrium of women with endometriosis. Study design Single cell suspensions of endometrial epithelial and stromal cells were cultured at densities of 20, 50, 100 and 200 cells/cm2. Cloning efficiency (CE) was determined, and stem cell phenotypic surface markers were detected using Western blotting and quantitative real-time polymerase chain reaction. Results CE was significantly higher in cells cultured at a density of 50 cells/cm2 compared with the other groups. After 15 days of culture, small and large colonies were observed. Large-colony-derived epithelial and stromal cells had high proliferative potentials, producing millions of cells in vitro, with strong expression of epithelial and stromal stem cell phenotypic surface markers EMA, CK, CD49f, THY-1(CD90), collagen type I, 5B5 and vimentin. Conclusion Adult stem cells were found in eutopic endometrium of women with endometriosis, and this may play an important role in disease development.
    European journal of obstetrics, gynecology, and reproductive biology 07/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The active form of vitamin D (1,25[OH]2D3) has been established to have potent anti-proliferative, immuno-modulatory, and anti-microbial action in addition to its effects on bone. The nuclear vitamin D receptor (VDR) is expressed in the placenta-decidua, regulating genes associated with implantation and implantation immuno-tolerance. If VDR polymorphisms regulate VDR functionality at the placenta-decidua interface, VDR genotypes may be involved in idiopathic preterm birth (PTB). Study design Maternal and fetal (umbilical cord) blood samples from 33 Jewish and Arab mothers with PTB of a singleton neonate were compared to 98 samples from Jewish and Arab maternal and fetal blood samples from full-term, uncomplicated singleton births. Maternal age and ethnicity were comparable between groups. PCR amplification/digestion identified the VDR SNPs: FokI, ApaI, TaqI, and BsmI. Results Allele frequency for the FokI VDR in maternal blood samples from preterm births (but not umbilical cord samples) was significantly different (p = 0.01) from that in maternal and umbilical cord blood samples from full-term singleton births, with an odds ratio for FokI carriers of 3.317 (95% CI, 1.143, 9.627) for preterm birth. The FokI VDR variant may therefore be a maternal risk trait for PTB among these women. Conclusion This study may support a future platform for the study of vitamin D during pregnancy and treatment of selective target populations with vitamin D and/or VDR “tissue-specific therapeutic intervention” for prevention of PTB
    European journal of obstetrics, gynecology, and reproductive biology 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective This study analyzed the ability of montelukast, a cysteinyl-leukotrienes receptor antagonist and anti-inflammatory agent, to produce a consistent tocolytic effect alone or in combination with nifedipine, a calcium (Ca2+) channel blocker currently used in clinical practice. Study design Uterine biopsies were obtained from consenting women undergoing elective cesarean sections at term (n = 20). Myometrial microsomal fractions were analyzed by immunoblotting to quantify relative cysteinyl leukotrienes receptor 1 (CysLTR1) levels. Isometric tension measurements were performed in vitro on human myometrial strips (n = 120) in isolated organ baths in order to establish concentration–response curves to montelukast and to quantify changes in Ca2+ sensitivity on β-escin permeabilized tissues. Results Immunodetection analysis revealed the presence of CysLTR1 receptor in uterine tissues, fetal membranes and placenta. A significant increase in area under the curve (AUC) was quantified following the addition of leukotriene D4 (LTD4) (0.01–0.3 μM), an end-product of the lipoxygenase pathway. Conversely, addition of montelukast produced a significant tocolytic effect by decreasing the frequency and AUC (IC50 = 1 μM). Moreover, addition of montelukast also resulted in a reduced Ca2+ sensitivity as compared to control tissues (EC50 values of 654 and 403 nM; p = 0.02 at pCa 6), while an additive effect was observed in combination with 0.1 nM nifedipine (p = 0.004). Conclusion This original study demonstrates the potency of montelukast as a tocolytic agent in an in vitro human uterine model. Montelukast, in combination with nifedipine, could represent a therapeutic approach to reduce inflammation associated with prematurity while facilitating the inhibition of preterm labor.
    European journal of obstetrics, gynecology, and reproductive biology 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To evaluate global and single gene methylation patterns as a sign for epigenetic modulation of the immune system in infants born by elective cesarean section (CS) and vaginal delivery (VD). Study design For this prospective pilot study a two step approach was chosen. Initially 41 newborn infants comprising 23 delivered by VD and 18 delivered by elective CS were included. Global DNA methylation of umbilical cord blood was determined. In a second step, methylation status of 96 single genes linked to T cell activation, cytokine production, inflammatory response, and stem cell transcription was evaluated in 48 newborn infants, 20 delivered by VD and 28 delivered by CS. Results Global methylation did not differ significantly between CS and VD (p = 0.732). The methylation status was low (threshold: ≤3%) for the majority of single genes (n = 92) in both groups. FOXP3, CD7, ELA2, and IRF1 showed hypermethylation in both groups. In the CS group, ELA2 (p < 0.001) and IRF1(p = 0.017) showed significantly higher methylation compared to the VD group. Conclusion We found no difference in global methylation between newborn infants in the VD group compared to the elective CS group. Methylation of single genes was significantly higher in newborn infants delivered by elective CS. Further research is needed to determine the significance of theses findings.
    European journal of obstetrics, gynecology, and reproductive biology 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To evaluate the verbal and written preoperative information in patients undergoing surgery for malignant gynaecologic disease, in terms of satisfaction about preoperative received informations, hospitalization days, postoperative pain experienced using visual analogue scale (VAS) and number of pain drugs used daily. Study Design From January 2008 to December 2012, consecutive patients with diagnosis of endometrial cancer, referred to the Division of Gynecology of University Campus Bio-Medico of Rome, were enrolled. Eligible subjects were randomized into two groups: Group V (Verbal information ward) consisted of patients who had verbal preoperative information about surgical procedure and postoperative management and Group W (Written Information ward) consisted of patients who had written preoperative information. All preoperative and postoperative data were recorded. Concerning satisfaction about preoperative received informations, patients were asked to complete the QLQ-C30 and the EORTC INFO25. Results 190 patients were considered in this study. Group W (n = 92) has a better info satisfaction (p = 0.0008, statistically significant), a mean VAS value lower (p = 0.02, statistically significant) and also a lower number of hospitalization days (p = 0.0265, statistically significant) and pain medications used daily, (p = 0.0120, statistically significant), comparing with group V (n = 98). Conclusions We support the use of preoperative information leaflet to better prepare patients for a surgical procedure, showing a faster recovery, low medications use and a better quality of life outcome.
    European journal of obstetrics, gynecology, and reproductive biology 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To detect endometriosis by urine peptide biomarkers using magnetic beads-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and to identify interesting peptides using liquid chromatography tandem mass spectrometry. Study design: Prospective case-control study in a university-based gynecological department and central laboratory. A total of 122 patients suffering from dysmenorrhea, pelvic pain and infertility were enrolled in the study. Urine samples were collected before laparoscopy. Urine samples were analyzed by the MALDI-TOF technique to generate peptide profiling and ClinProTools software was used to set up a diagnostic model for endometriosis. Liquid chromatography tandem mass spectrometry (LC-MS/MS) was used to identify interesting peptides. Results At laparoscopy 60 patients were diagnosed with endometriosis and 62 patients were disease-free. There were 36 different peptides expressed in endometriosis patients detected by MALDI-TOF compared with controls. We established a genetic algorithm as a diagnostic model with the combination of five peptides (m/z = 1433.9, 1599.4, 2085.6, 6798.0 and 3217.2). The model showed a sensitivity of 90.9% and specificity of 92.9%. Urine from another 26 symptomatic patients before laparoscopy were randomly selected and analysed accordingly. A genetic algorithm showed a sensitivity of 90.9% and specificity of 92.9% in predicting endometriosis before laparoscopy. We also identified two peptides not belonging to the diagnostic model as collagen precursors. Conclusions Patients with endometriosis have a unique cluster of peptides in urine. Peptide proteomic profiling provides a novel method for non-invasive diagnosis of endometriosis
    European journal of obstetrics, gynecology, and reproductive biology 06/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the diagnostic potentials of the serum levels of nine different biomarkers in endometriosis. In this case-controlled, prospective clinical study, 80 women underwent laparoscopy or laparotomy with a preliminary diagnosis of chronic pelvic pain, severe secondary dysmenorrhea, infertility, pelvic endometriosis or pelvic mass. The 60 women with confirmed pelvic endometriosis constituted the endometriosis group, and the other 20 women without endometriosis constituted the control group. Preoperative blood samples were obtained for serum biomarker measurements. Serum levels of nine different serum biomarkers including α-enolase, macrophage migration inhibitory factor, leptin, interleukin-8, anti-endometrial antibody, phosphoinositide dependent protein kinase 1, CA125, syntaxin-5, and laminin-1 were measured concurrently and compared between the control and endometriosis groups, and among control group and endometriosis subgroups including stage I, stage II, stage III and stage IV endometriosis. The serum levels of α-enolase, macrophage migration inhibitory factor, leptin, interleukin-8 and antiendometrial antibodies showed a statistically significant difference neither between control and endometriosis groups nor among control group and endometriosis subgroups. The serum levels of CA125, syntaxin-5 and laminin-1 showed a statistically significant difference both between the control and endometriosis groups (p<0.01) and among control group and endometriosis subgroups (p<0.01). Serum levels of laminin-1 in stage II and IV endometriosis; syntaxin-5 in stage I and II endometriosis; and CA125 in stage III and IV endometriosis were found to have the different levels compared to control group. These findings show that the concurrent measurement of CA125, syntaxin-5 and laminin-1 might be a useful non-invasive test in strengthening the diagnosis of endometriosis and in predicting its severity.
    European journal of obstetrics, gynecology, and reproductive biology 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective Women with late preterm premature rupture of membranes (PROM) have an increased risk that their child will develop neonatal sepsis. We evaluated whether neonatal sepsis can be predicted from antepartum parameters in these women. Study design: We used multivariable logistic regression to develop a prediction model. Data were obtained from two recent randomized controlled trials on induction of labor versus expectant management in late preterm PROM (PPROMEXIL trials, (ISRCTN29313500 and ISRCTN05689407). Data from randomized as well as non-randomized women, who consented to the use of their medical data, were used. We evaluated 13 potential antepartum predictors for neonatal sepsis. Missing data were imputed. Discriminative ability of the model was expressed as the area under the receiver operating characteristic (ROC) curve and a calibration with both a calibration plot and the Hosmer and Lemeshow goodness-of-fit test. Overall performance of the prediction model was quantified as the scaled Brier score. Results We studied 970 women. Thirty-three (3.4%) neonates suffered neonatal sepsis. Maternal age (OR 1.09 per year), maternal CRP level (OR 1.01 per mmol/l), maternal temperature (OR 1.80 per °Celsius) and positive GBS culture (OR 2.20) were associated with an increased risk of neonatal sepsis. The model had an area under the ROC-curve of 0.71. The model had both a good calibration and accuracy. Conclusions Antepartum parameters aid in the more precise prediction of the risk of neonatal sepsis in women with late preterm PPROM.
    European journal of obstetrics, gynecology, and reproductive biology 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives To establish red fluorescent human endometriosis lesions in a nude mouse model and dynamically and non-invasively to compare intraperitoneal and subcutaneous injection models. Study design: Primary cultures of endometrial stromal cells (ESCs) and epithelial cells (EECs) isolated from 24 patients with a normal uterine cavity were transfected with 2.5 × 108 (Group 1) and 1.25 × 108 (Group 2) plaque-forming units (PFU) of adenovirus encoding red fluorescent protein (Ad-RFP). Transfection efficiencies, fluorescence intensity and apoptosis rate of the two types of cells were compared in vitro. A mixture of 2.5 × 108 PFU Ad-RFP-infected approximately 400 EECs cell mass and 2 × 106 ESCs for 36 h was injected individually into 24 female nude mice subcutaneously (Group A) or intraperitoneally (Group B). From Day 5 after injection, an In Vivo Imaging System (IVIS) was used to non-invasively observe and compare the lesions of the two groups every week until Day 33. Specifically, the fluorescent intensity, positive rates, persistence time and lesion weight in the implanted human endometriosis lesions were compared. A parametric Student's t-test and two-way analysis of variance were used for statistical analysis. Results Compared with 1.25 × 108 PFU RFP, a titre of 2.5 × 108 PFU RFP ESCs and EECs incubated for 36 h exhibited higher transfection efficiencies and higher fluorescence intensities in vitro. In vivo imaging of the fluorescent human endometriosis lesions originating from an RFP titre of 2.5 × 108 PFU showed that the intensity and lesion weight in Group A were significantly higher than in Group B. However, the two groups had the same RFP-positive rates and fluorescence persistence. The structure of each lesion was evaluated by immunohistochemistry to confirm its human endometrial origin. Conclusions The red fluorescent human endometriosis model established by subcutaneously injecting 2.5 × 108 PFU RFP-transfected stromal cells and epithelial cells into nude mice had a higher fluorescent positive rate from Day 5, higher intensity and weight but the same persistence as the intraperitoneal injection model.
    European journal of obstetrics, gynecology, and reproductive biology 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To draw attention to the rare condition of endometriosis in the bladder. This is correlated with symptoms not normally connected to endometriosis and therefore often remains underdiagnosed for years. Design and setting: Retrospective study.in a university teaching hospital, one of two referral centres in Denmark for surgical treatment of stage III and IV endometriosis. Population: Thirty-one women with deep infiltrating bladder endometriosis. Methods All women presenting in the Department of Obstetrics and Gynaecology with deep infiltrating bladder endometriosis between March 2002 and March 2011. We included only patients with symptomatic full-thickness bladder detrusor endometriosis and mucosal involvement. All patients had had bladder symptoms for two to seven years. Main outcome measures.Symptoms after surgery and recurrence rate. Results The main preoperative symptom was urinary frequency. All patients had significant relief of symptoms after operation, and none had recurrence of the bladder endometriosis jugded by ultrasound or reported symptoms. Twenty-six (87%) patients had endometriosis in another location as well. Eight had nodules in the recto-vaginal septum. Complete surgical excision of all associated endometriotic lesions was carried out during the same surgical procedure. During the mean follow-up period of 59 months no long-term complications were diagnosed. Conclusion Bladder endometriosis should be considered in patients who present with irritative urological symptoms with aggravation during menstruation or in patients with a history of endometriosis. When patients have symptoms we recommend surgical treatment in cases where medical treatment fails.
    European journal of obstetrics, gynecology, and reproductive biology 05/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective To compare the incidence of gestational diabetes mellitus (GDM) between pregnancies conceived spontaneously and pregnancies conceived following assisted reproductive technology (ART). Study design This cross-sectional study evaluated the medical records of 215 women who conceived spontaneously and 145 women who conceived following ART from September 2011 to October 2012. Exclusion criteria were: polycystic ovary syndrome, maternal age ≥40 years, family history of diabetes in first-degree relatives, pre-pregnancy diabetes, glucose intolerance treated with hypoglycaemic agent (e.g metformin), history of GDM, history of stillbirth, recurrent miscarriage, history of baby with birth weight ≥4 kg (macrosomia), parity >3, Cushing syndrome, congenital adrenal hyperplasia and hypothyroidism. For better comparison of the incidence of GDM, the ART group was further subdivided into: (i) an in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) group (n = 95); and (ii) an intrauterine insemination (IUI) group (n = 50). The diagnosis of GDM was based on the criteria of the American Diabetes Association. Results The incidence of GDM was significantly higher in the IVF/ICSI and IUI groups (43% and 26%, respectively) compared with the spontaneous pregnancy group (10%). Age, pre-pregnancy body mass index (BMI) and weight gain in pregnancy were similar among women with GDM in all three groups. In addition, the incidence of pregnancy-induced hypertension was significantly higher in the IVF/ICSI group (21%) compared with the spontaneous pregnancy group (7%). Logistic regression analysis demonstrated four strong risk factors for GDM: age, BMI, mode of ART and progesterone use during pregnancy. Conclusion This study indicated that the risk of GDM is two-fold higher in women with singleton pregnancies conceived following ART compared with women who conceived spontaneously. In addition, progesterone use during pregnancy was found to be an important risk factor for GDM. This subject requires further study.
    European journal of obstetrics, gynecology, and reproductive biology 05/2014;