Laparoscopic management of ovarian mature cystic teratomas

To evaluate the safety and efficacy of laparoscopic management of dermoid cysts, to present some guidelines, and to avoid possible complications that may occur from cyst spillage. A retrospective review of twenty-four women, who underwent laparoscopic surgery for dermoid cysts. Cases were recruited during the period from March 2002 to May 2005 at Shatby University Maternity Hospital, using special technique during laparoscopic removal of dermoid cysts. All patients were counseled for the procedure and informed consent was obtained to do laparoscopic management. In 24 women aged 18 to 38 years, thirteen patients [54.2%] had unilateral cysts, while eleven patients [45.8%] had bilateral cysts. The size of the dermoid cysts ranged from one to ten centimeters, mean cyst diameter was, 4.7 +/- 2.9 cm, and all these cysts removed via the use of endobag. The chief complaint was chronic pelvic pain in 11 patients [45.8%], irregular menstrual cycles in 4 cases [16.7%], one case [4.2%] presented with acute abdomen and torsion, while 8 cases [33.3%] were asymptomatic and discovered incidentally during routine ultrasound examination. All patients underwent operative laparoscopic cystectomy of the dermoid cysts. During the cyst extraction, spillage occurred in 4 cases [16.6%], and none developed chemical peritonitis. Operative time for dermoid cyst removal was 103 +/- 30 minutes. There were no intraoperative or postoperative complications, and no conversion to laparatomy. Using strict adherence to guidelines for preoperative clinical assessment and intra-operative management, laparoscopic treatment of dermoid cysts appears to be a safe procedure

Diagnostic value of beta-HCG, estradiol, and progesterone in ectopic pregnancy versus normal-intrauterine pregnancy

To evaluate the diagnostic value of rising level of serum beta subunit human chorionic genadotrophin, single measurement of progesterone, and estradiol in early diagnosis of ectopic pregnancy. A case control study was conducted on 40 women with ectopic pregnancy and 40 women with normal intrauterine pregnancy from Shatby University Maternity Hospital. Blood samples for the measurement of beta subunit human chorionic genadotrophin [beta-hCG], estradiol [E2], and progesterone were drawn in all the women upon admission. Extra blood sample was drawn for measurement of beta-hCG 24 hours after admission. The mean serum levels of beta-hCG, progesterone, and estradiol in patients with ectopic pregnancies [969.0 +/- 302.1, 7.9 +/- 2.83, 621.9 +/- 131.4 respectively] were significantly lower than these levels in normal intrauterine pregnancies [3186.8 +/- 649.2, 23.5 +/- 5.3, 1853.6 +/- 508.4 respectively]. The average rate of beta-hCG rising was [8%] for 24 hours in patients with ectopic pregnancy and [31%] in normal intrauterine pregnancies. Single measurement of serum progesterone level has the greatest sensitivity [97%] and specificity [90%] in the diagnosis of early ectopic pregnancy