ABSTRACT
We want to compare the efficacy and safety of vaginal versus sublingual misoprostol for cervical ripening and induction of labor. This randomized clinical trial was performed on 140 women with medical or obstetric indications for labor induction. The patients were randomly divided into two groups: vaginal and sublingual administration of misoprostol. In first group, 25 Micro g misoprostol was placed in the posterior fornix of the vagina and second group received 25 Micro g misoprostol sublingually, every 6 hours for 24 h. Maternal and neonatal outcomes were analyzed. There was no significant difference in the demographic characteristics between two groups. The main indication for cesarean section in both groups was fetal distress, followed by absence of active labor progress. Evaluation of cesarean indication was not significantly different in two groups; including fetal distress, absence of active labor, uterine over activity and failure to progress. The maternal complication in sublingual group included residual placenta [2%], tachysystole [2%], vomiting [12%], atoni [3.3%] and abdominal pain [5.5%], although there was no significant difference between two groups. Sublingual misoprostol is as effective as vaginal misoprostol for induction of labor at term. However, sublingual misoprostol has the advantage of easy administration and may be more suitable than vaginal misoprostol
ABSTRACT
Background: In molar pregnancy, when hydatidiform changes are local and some embryonic components are observed, the term of partial mole is used. The risk of persistent trophoblastic tumor after partial mole is much lower than complete mole. In this persistent cases almost all are non metastatic. The aim of this study is to report a case of uterine rupture following incomplete molar pregnancy
Case presentation: The patient was a 26 year old woman with obstetric history of an abortion and one molar pregnancy and no child. She was referred to emergency unit in Ghaem University Hospital, Mashhad, Iran in May 2011. She had an evacuation curettage following molar pregnancy three months before and without any follow up visit. The patient was referred to emergency unit with hemorrhagic shock. She immediately underwent laparotomy. The uterine fundal rupture was repaired and evacuation curettage performed. In post operative evaluation, she had a nine millimeter metastatic nodule in base of right Lung. As a patient in low risk stage III, she received weekly intramuscular methotrexate [40mg/m2] for six courses. In follow up visit beta-hCG titer was negative [<10miu/ml] at 5th week
Conclusion: In cases of in complete molar pregnancy risk of metastasis is very low. Serial beta-hCG titer is the most accurate method for detection of persistent gestational trophoblastic disease [GTN]. In neglected cases like this case preservation of ruptured uterus in GTN is possible
ABSTRACT
Ovarian hyperstimulation syndrome [OHSS] is the most serious and potentially life-threatening iatrogenic complication associated with ovarian stimulation during Assisted Reproductive Technology [ART] protocols. OHSS typically is a result of ovarian expression of vascular endothelial growth factor [VEGF] which increases vascular permeability. Comparison of albumin and cabergoline in the prevention of OHSS.95 high risk infertile women for OHSS [more than 20 follicles in both ovaries at day of Human Chorionic Gonadotropin [HCG] injection] were randomly divided into two groups. First group including 48 women received 10 unit intravenous albumin at starting oocyte retrieval, and second group including 47 women received 0.5 mg/day dopamine agonist [Cabergolin] at day of HCG injection till 8 days. The dosage of human Menopausal Gonadotropin [HMG] used, total number of follicles developed, number of oocytes retrieved, serum E2 concentrations during the luteal phase, development of ascites, number of embryos generated, clinical pregnancy rate, results of the in vitro fertilization-embryo transfer [IVF-ET] cycles and incidence and severity of any OHSS were evaluated. There was evidence of a statistically significant reduction in the incidence of OHSS in the cabergolin group [53.7%] versus albumin group [46.3%] [p=0.04]. But there was no significant difference of a reduction in severe OHSS [p=0.62]. There was no difference in clinical pregnancy rate too. Administration of cabergolin can prevent incidence of OHSS and does not appear to effect on its severity
Subject(s)
Humans , Female , Albumins , Ergolines , Dopamine AgonistsABSTRACT
Placenta accreta is a life-threatening complication after previous cesarean delivery. The aim of this case report is to present a case of placenta percreta with bladder involvement and subsequent maternal death. The patient was a 37-year old who had an unwanted pregnancy due to tubectomy failure two years afterwards. She was hospitalized at 26th and 30th week of gestation because of gross hematuria. Sonography reported placenta previa. Cesarean section was performed at 34th gestational week. Due to severe hemorrhage, hysterectomy with resection of some part of the bladder was done. Died at the operating room after four hours of severe uncontrollable hemorrhage. The increasing prevalence of different forms of placenta accreta is the result of the ever-increasing rate of cesarean deliveries. One of the strategies to prevent this catastrophic obstetric complication is decreasing the number of cesarean deliveries without appropriate indications
Subject(s)
Humans , Female , Fatal Outcome , Pregnancy , Urinary Bladder/pathology , Hematuria , Cesarean SectionABSTRACT
Despite the important implication for women's health and reproduction, very few studies have focused on vaginal PH for menopausal diagnosis. Recent studies have suggested vaginal PH as a simple, noninvasive and inexpensive method for this purpose. The aim of this study is to compare serum FSH level with vaginal PH in menopause. This is a cross-sectional, descriptive study, conducted on 103 women [aged 31-95 yrs] with menopausal symptoms who were referred to the Menopausal Clinic at Ghaem Hospital during 2006. Vaginal pH was measured using pH meter strips and serum FSH levels were measured using immunoassay methods. The data was analyzed using SPSS software [version 11.5] and results were evaluated statistically by the Chi-square and Kappa tests. P 4.5, and serum FSH as >/= 20 mIU/ml, then the sensitivity of vaginal pH for menopausal diagnosis was 97%. The mean of FSH levels in this population was 80.79mIU/ml. Vaginal pH is a simple, accurate, and cost effective tool that can be suggested as a suitable alternative to serum FSH measurement for the diagnosis of menopause