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

Menstrual blood loss of TCU-380A and TCU-200B IUDs

Menstrual blood loss [MBL] increases after IUD insertion, yet this increase could be decreased when Copper [Cu] is added to IUD, The degree of decrease of MBL is directly proportioned to the surface area of [Cu] added. The present study was conducted on 50 women [25 fitted with TCu-200 B and 25 fitted with TCu-380 A. The MBL was estimated in both groups; on preinsertion cycle [control] and on the 1st, 3rd, 6th, and 12th postinsertion cycles; using the atomic absorption spec-trophotometer technique. The MBL was significantly higher in the postinsertion cycles as compared to the preinsertion cycle in both groups [P < 0.05]. Although there was an increase of MBL in postinsertion cycles in the studied groups, yet this increase was significantly lower in women fitted with TCu-380 A as compared to those fitted with TCu-200 B. The removal rates for bleeding were 0 and 8. / per 100 women year respectively for the TCu-380 A and TCu-200 B IUD users

Ovulation pattern in adolescent dysfunctional uterine bleeding

The adolescent years present a vulnerable period of time during which menstrual abnormalities may arise. This work is designed to determine on histopathological basis the ovulation pattern in 29 teenage women with dysfunctional uterine bleeding. Fundal endometrial curettings were taken on the 22 [nd] day of averaged cyclic menses and during the first 8 hours of the first day of the flow in a cyclic menses. Ovulation was documented in 96,55 percent of cases, and the remaining 3.45 percent were anovulatory. 62.07 percent of the ovulatory women had good secretory endemetrium and the remaining 34.48 percent had weak secretory endemetrium; luteal phase defect. Only 3.45 percent of the 29 studied cases had anovulatory menses with cystic glandular hyperplastic endemetrium. It can be concluded that dysfunctional uterine bleeding may occur from any type of endemetrium

Glycosylated haemoglobin and one-hour oral glucose screen for gestational diabetes

A prospective study was undertaken to evaluate the use of glycosylated haemoglobin [Hb A[1]] as a screening tool for the detection of gestational diabetes in 30 women. At 24 - 38 weeks, these patients had an Hb A[1] determination prior to diabetes secreening with a 1-hour serum glucose after 50 gm of oral glucose load. 27 out of 30 [90%] high-risk women had normal I-hour serum glucose [< 140 mg%]. 13 out of these 27 women [48.15%] had an abnormal Hb A[1] [>8.8%]. 3 out of 30 [10%] high-risk women had abnormal 1-hour glucose screen. All of them had abnormal Hb A[1]. So abnormal Hb A1 had been documented in 16 out of 30 [53.33%] studied risk cases. It can be concluded that Hb A[1] screen is more reliable than I-hour glucose screen

Serum human placental lactogen [hpl] in normal, toxaemic and diabetic pregnant women, during pregnancy and its relation to the outcome of pregnancy

Human placental lactogen [HPL] levels in serum were measured by radial immunodiffusion plates and immunoelectrophoresis in twenty normal, nineteen toxaemic and fourteen diabetic pregnant women, followed up during the first trimester [10-12 w.], the second trimester [20-22 w.], the 28th week, the 32nd week, the 36th week and two weeks after delivery. Serum human placental lactogen concentration showed progressive increase with the advance of pregnancy in all groups. It was not detected when measured two weeks after delivery in normal, toxaemic and diabetic pregnant women. Comparing the mean serum concentration in toxaernic pregnant patients with that in the normal group, the toxaemic group had lower mean serum hpl concentration throughout the period of pregnancy. On the other hand, diabetic pregnant women showed higher serum hpl concentration than normal pregnant women throughout the period of pregnancy. There was a positive correlation between infant weight, infant length and serum hpl levels at the 28th, 32nd weeks of gestation. Our results indicate that serial determination of serum hpl may he a valuable complement to other diagnostic aids in the supervisior of pregnancies, complicated by pre-eclampsia or diabetes

Pre-eclamptic toxanemia and its relation to HLA system

The study of Histocompatibility Locus Antigen [H.L.A.] frequencies in 20 cases with severe pre-eclampsia in Cairo showed H.L.A. Al, and H. L A B8 are the only antigens that show significant positive association, while negative association was observed between HL A-A28 and PET, when compared with control group