Transvaginal sonographic assessment of endometrial status in pre- and postmenopausal women before hormone replacement therapy (HRT)

Estrogen plays an important role in the genesis and growth of gynecological tumor. Transvaginal sonography assessment of endometrial status is most commonly used in menopausal women to investigate significant findings before hormone replacement therapy (HRT) in pre- and postmenopausal women. One hundred and eighty-six pre- and postmenopausal women with no known history of HRT were transvaginally measured for endometrial thickness of the uterus and pelvic organs. Their age (mean ± standard deviation) was 51.4 ± 5.8 years (range 38 – 75 years); 48.4% were in pre-menopause group, the rest were in post-menopause group. In the latter group, most of them (64%) had had amenorrhoea for 1-5 years. The endometrial thickness in post-menopause group was 4.7 ± 3.4 mm (0 – 22 mm). Myoma was found in 10 cases (5.4%) and ovarian cyst in 6 (3.2%). There were six cases (3.2%) of endometrial hyperplasia. Transvaginal sonography would be useful in the evaluation of endometrium and pelvic organs before HRT

A comparison between 50 mcg oral misoprostol every 4 hours and 6 hours for labor induction: a prospective randomized controlled trial.

OBJECTIVE: To compare the effectiveness and safety between 50 mcg oral misoprostol every 4 hours and 6 hours for labor induction. DESIGN: A prospective randomized controlled trial. SETTING: Department of Obstetrics & Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. SUBJECTS: Eighty nine pregnant women of at least 34 weeks' gestation with indications for labor induction in the condition of unfavourable cervix (Bishop score < or = 4) and no contraindication to prostaglandin therapy. INTERVENTIONS: All pregnant women were randomized to receive either 50 mcg misoprostol orally every 4 hours or 6 hours. MAIN OUTCOME MEASURES: Treatment interval from induction to vaginal delivery, maternal and neonatal complication. RESULTS: The mean treatment intervals from induction to vaginal delivery were 22.10 +/- 18.49 hours and 20.91 +/- 11.98 hours in the misoprostol group every 4 hours and 6 hours, respectively. The treatment intervals between the two groups were not statistically significant. There was also no significant difference between both groups with regard to maternal and neonatal complications. CONCLUSION: The effectiveness in terms of treatment interval from induction to vaginal delivery were comparable between the two groups, but administration of misoprostol every 6 hours was found to have a slightly shorter interval, although it did not reach statistical significance. No serious maternal and neonatal complication was demonstrated in both groups. Either regimen in this study can be an alternative for labor induction.

Second trimester pregnancy termination with 800 mcg vaginal misoprostol.

OBJECTIVE: To demonstrate the efficacy of 800 microgram vaginal misoprostol tablet for second trimester pregnancy termination. DESIGN: Prospective descriptive study. SETTING: Maharaj Nakorn Chiang Mai Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University. SUBJECT: Pregnant women meeting the inclusion criteria including (1) singleton pregnancy with live fetus, (2) gestational age of 14-28 weeks, (3) indication for therapeutic termination, (4) closed and uneffaced cervix, (5) absence of uterine contraction and leakage of amniotic fluid, (6) no previous classical uterine scar, (7) no contraindication for misoprostol such as hypersensitivity. INTERVENTION: 800 microgram misoprostol tablet intravagina every 12 hours. MAIN OUTCOME MEASURES: Mean induction delivery time, mean abortion time, maternal side effects. RESULTS: The mean induction delivery time was 21.38 + 13.68 hours, mean abortion time was 21.56 +/- 13.68 hours. Diarrhea was the most common side effect occuring in 40 per cent of patients. CONCLUSIONS: 800 mcg vaginal misoprostol every 12 hours is effective but if we want high efficacy along with fewer side effects, lower dose and interval should be further studied.

Therapeutic termination of second trimester pregnancy with vaginal misoprostol.

OBJECTIVE: To evaluate the efficacy of vaginal misoprostol in therapeutic termination of second trimester pregnancy with a live fetus. DESIGN: Prospective descriptive study. SETTING: Maharaj Nakorn Chiang Mai Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University. SUBJECTS: Pregnant women meeting the inclusion criteria including 1) pregnancy with a live fetus, 2) gestational age of 14-28 weeks, 3) having an indication for therapeutic termination, 4) Bishop's score of < or = 4, 5) absence of uterine contraction and leakage of amniotic fluid, 6) no previous classical uterine scar and 7) no contraindication for misoprostol such as hypersensitivity. INTERVENTION: 400 microgram misoprostol gel intravagina every 12 hours. MAIN OUTCOME MEASURES: Mean induction-delivery time, mean abortion time, maternal side effects. RESULTS: Sixty eight pregnant women were recruited into the study. The mean induction-delivery time was 35.58 +/- 34.13 hours, mean abortion time was 35.80 +/- 34.13 minutes. Fever was the most common side effect occuring in about two-third of the patients, but no serious maternal complication was observed. CONCLUSION: 400 microgram vaginal misoprostol is effective for therapeutic termination of second trimester pregnancy with no serious side effects. However, the response to this treatment was markedly varied from patient to patient.