ABSTRACT
To discuss the diagnosis and treatment of jugular vein thrombosis, subclavian vein thrombosis and the right brachiocephalic vein thrombosis after in vitro fertilization and embryo transfer (IVF-ET)cycles in clinical practice. The clinical data regarding a case of jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis in IVF-ET were reviewed. Clinical characteristics, prevention and treatment of jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis in IVF-ET were discussed. A woman with secondary infertility underwent an IVF cycle with prolonged protocol controlled ovarian hyperstimulation. The oestradial concentration was 2 495 pg/mL on the day of human chorionic goeadotrophin (hCG). Fifteen occytes were retrieved and 2 embryos were transferred. Nine days after the embryos were transferred, the patient had ascites,hydrothorax and fluid of pelvic cavity accumulating, and was hospitalized. The patient underwent volume expansion and paracentesis, and left the hospital 30 days after the embryo transfer. Her right neck had pain 43 days after the embryo transfer. B ultrasound showed jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis. The patient underwent low molecular weight heparin anticoagulation and low molecular weight dextran expansion, and left hospital with symptoms improved. She had Caesarean section and had a healthy baby girl. The thrombosis in the IVF-ET was a rare and serious complication. Prevention of ovarian hyperstimulation syndrome (OHSS) may reduce the incidence. The patients had local pain, swelling, skin temperature increased, headache, neck pain, and had to be checked to determine whether there were blood clots. The main treatment was low molecular weight heparin anticoagulation and low molecular weight dextran expansion. Timely Cesarean section is recommended to ensure the safety of perinatal mother and child.
Subject(s)
Adult , Female , Humans , Brachiocephalic Veins , Embryo Transfer , Fertilization in Vitro , Heparin, Low-Molecular-Weight , Therapeutic Uses , Jugular Veins , Ovarian Hyperstimulation Syndrome , Subclavian Vein , Venous Thrombosis , Drug TherapyABSTRACT
Objective To compare the therapeutic effect of two Methodsof in vitro oocyte maturation (IVM) technology with polycystic ovary syndrome (PCOS) patients in infertility treatment.MethodsRetrospective analysis was performed on patients with PCOS infertility who were stimulated with two different kinds of stimulating method of the IVM cycle in our center during April 2010 and August 2010.There were 20 patients in the temporary FSH stimulating group (group A) and 31 patients in the HCG stimulating group (group B).The number of oocytes maturation rate,fertilization rate,cleavage rate,excellent embryo rate,implantation rate,pregnancy rate per oocyte recycle,pregnancy rate per transfer and abortion rate of transfer were compared.ResultsThere was no significant difference between the two groups of age,duration of infertility,body mass index,based sex hormone levels by t test(P＞0.05).There was no significant difference between the two groups of the number of oocytes retrieved,oocyte maturation rate,cleavage rate,and abortion rate of transfer(P＞0.05).In group B,the fertilization rate was 80.3%,good-quality-embryo rate was 49.8%,implantation rate was 31.5%,pregnancy rate per oocyte recycle was 54.8%,which was significantly higher than in group A (73.9%,35.4%,12.5% and 25.0%,respectively).ConclusionsIf IVM was used to treat PCOS patients with infertility,HCG stimulating will be better than FSH stimulating,and it could result in a higher clinical pregnancy rate.
ABSTRACT
Objecfive To investigate possibihty of monitoring myocardial isehemia by eontinuous EASI 12-lead ST-segment trend analysis during orthopaedic surgery and find its rules.Methods Three hundred and eleven consecutive patients who underwent orthopaedic surgery were monitored bv continuous EASI 12-lead ST-segment analysis during surgery.Results Among 311 patients 81 patients(26.0%) had myocardial ischemic events.The ischemie incidence of general anesthetics WaS signifieantly higher than local anesthetics(the spinal or epidural anesthetics and nerve-block anesthetics)(38.1%vs 23.0%.P＝ 0.01 5).During ischemie events the patients whose heart rate exceeded 90 beat per minute was 71.6% (58/81).Among the 177 isehemie events,the duration ofless than 5 minutes was 79.7%(141/177).ST-seg- ment deviation ofless than 0.15 mV was 71.2%(126/177).Conclusions During orthopaedic surgery EASt 12-lead electrocardiogram is the optimal approach for monitoring myocardial isehemia.The ischemic incidence of general anesthetics is significantly higher than local anesthetics.The myocardial ischemia events correlates with fast heart rate.The intraoperative myocardial ischemia events are more often transient.In most of these ischemic events ST-segment deviation is not very serious.