Laparoscopic ovarian electrocautery versus human menopausal gonadotrophin in the management of infertility due to polycytic ovarian disease

Either of electrosurgical laparoscopic ovarian drilling [LOD]or gonadotropin [hMG] therapy is the second choice for induction of ovulation in clomiphene citrate resistance patients with polycystic ovarian disease, this study aim to compare both modalities [LOD and hMG]. Comparative study Bab El-Sharia University Hospital. Seventy five patients with anovulatory infertility due to PCOD were recruited from infertility clinic, the patients subdivided into two groups : first group [40 patients] treated with hMG, and second group [35 patients] subjected to LOD. The results of menstrual pattern, hormonal response, ovulation pattern and occurrence of pregnancy were compared between both modalities of treatment. Improved menstrual pattern 90% versus 70%, ovulation rate 79% versus 75%, pregnancy rate 40% versus 32.5% in LOD and hMG treated groups respectively. The rate of twin pregnancy was 7% in LOD treated group versus 23% in hMG treated group. No abortion occurred with LOD compared with 23% abortion rate in hMG treated group. The outcome of pregnancies in LOD was 100% healthy live birth compared with 76.9% in hMG treated group. NO hyperstimulation associated with LOD. The results with LOD are some what superior to the results with hMG

Laparoscopic guided transcervical hysteroscopic tubal cannulation in the treatment of proximal tubal block

Proximal tubal obstruction [PTO] represent up to 25% of tubal disease in infertile women. Hysteroscopic tubal cannulation, tubal reanastamosis and IVF are the available modalities for the treatment of PTO The aim of this study is to evaluate the value of treatment of PTO using hysteroscopic tubal cannulation under laparoscopic guidance. Randomized study, Bab El Sharia University Hospital. Thirty infertile patients [either primary or secondary infertility] due to PTO as evidenced by hysterosalpingography were recruited from infertility clinic. Duration of infertility, history of pelvic inflammatory disease and any methods of contraception were asked for. Immediately after menstruation combined laparoscopy and hysteroscopic tubal cannulation were done for each patient. Hysteroscopic tubal cannulation successfully re-established tubal patency in forty [83.33%] out of forty eight tubes originally diagnosed with PTO. No significant relation between success of recanalization and either of duration of infertility, history of PID, method of contraception or type of infertility. There was significant relation between incidence of tubal perforation and duration of infertility as well as history of IUD

Pregnancy outcome and feto-placental blood flow in hypotensive pregnant women

To examine the effect of maternal hypotension on the feto-placental blood 110w, placental morphology and pregnancy outcome. Observational [prospective]study. Bab El Shaareia and El Hussein University Hospitals, Cairo. The study population consisted of 267 singleton pregnant women between the 26th to 38th week. They were divided into: a study group consisted of 117 hypotensive women with BP?90/60mmHg and a control group of 150 normotensive women with BP between 140/90mmHg. For both groups foetal biophysical profile and Doppler study of the umbilical and middle cerebral arteries were performed every 2-4 weeks. We examined the gestational age at delivery, birth weight, mode of delivery, Apgar score, possible fetomaternal complications and placental gross and microscopical features. In the hypotensive group the mean maternal weight gain was less, the umbilical A/B and RI were higher, middle cerebral artery PI was lower, the biophysical profile was lower, gestational age at delivery, birth weight was lower, Apgar score at 1 min. Was lower, abnormal perinatal outcome were higher, while placental calcification was significantly increased, all when compared to the control group, on the other hand the mean maternal age, mode of delivery, Apgar score at 5min. and placental weight show no significant difference when compared to the control group. Hypotension during pregnancy is a risky condition which we have to care for and hypotensive pregnant women should be monitored all through pregnancy