Monopolar versus bipolar electrosurgery in hysteroscopic polypectomy

The aim of this study is to compare in random manner the intraoperative feasibility, effectiveness and safety of monopolar and bipolar electrosurgery in hysteroscopic polypectomy. 36 Symptomatic patients attending at outpatient clinics and diagnosed to have intrauterine polyps by HSG, transvaginal sonography or Diagnostic hysteroscopy were included. Patients were randomly assigned to two groups to have hysteroscopic polypectomy using either bipolar [Group A] or monopolar [Group B] electrosurgery under general anesthesia. Intraoperatively, the following parameters were noted and recorded: time of start of anesthesia, time of introduction of the resectoscope, time of end of the procedures, time of recovery, amount of fluid used, amount of fluid Collected in the graduated suction, postoperative serum sodium was measured. Sociodemographic data for patients in both groups were comparable. The mean duration of operation was comparable in both group [14.76 +/- 2.95 minutes in bipolar group versus 14.79 +/- 2.94 minutes in monopolar group]. Fluid inflow, fluid outflow and fluid deficit were significantly higher in the monopolar group than in bipolar group. Bipolar electrosurgery seems effective, feasible and safe alternative to conventional monopolar system in hysteroscopic management of intrauterine pathologies

Fetal cardiovascular hemodynamics in diabetic and hypertensive pregnancies

Fetal echocardiography is a useful technique in the evaluation of the fetal cardiovascular system. The purpose of this work was to evaluate fetal cardiac anatomy and function in two of the most common medical problems seen in pregnancy, diabetes mellitus and chronic maternal hypertension. In this cross sectional study, 60 fetuses between 20-30 weeks of gestation were included. Twenty of them were fetuses of diabetic mothers [FODMs], 20 fetuses of hypertensive mothers [FOHMs] and the remaining twenty were normal fetuses of matchable gestational age as controls. Transabdominal fetal echocardiography was obtained and the cardiac diameters and thickness were measured. The systolic function [stroke volume and cardiac output] and the diastolic function [E/A ratio] were obtained. There was a significant increase in cardiac diameters and thickness in FODMs and decrease in diameters in FOHMs. The pulmonary and aortic blood flow velocities were significantly faster in FODMs and slower in FOHMs. The diastolic functions were impaired in all patients. The stroke volume and cardiac output were significantly higher in FODMs and lower for the right ventricule in FOHMs than controls. Fetal echocardiographic examination showed significant changes in both cardiac anatomy and function in FODMs and FOHMs. The practical value of this non invasive technique is in need for further prospective comparative studies with the well established methods in obstetric decision making