ABSTRACT
OBJECTIVE: The aim of this study was to compare the efficacy of sacrospinous colpopexy without hysterectomy and with hysterectomy for symptomatic uterine prolapse. METHODS: A retrospective chart review was performed in the women who underwent sacrospinous ligament suspension between March 1998 and March 2002. A hundred fifty five women with a symptomatic uterine prolapse were treated with either sacrospinous colpopexy without hysterectomy and/or anterior-posterior repair (83 cases=Group A) or sacrospinous colpopexy with hysterectomy and/or anterior-posterior repair (72 cases=Group B). RESULTS: The mean duration of surgery, hemoglobin change, catheter days and inpatient days were shorter in group A compared with group B. (Group A 102.5+/-33.4 min, 2.4+/-0.7 mg/dL, 5.2+/-1.4 days, 7.6+/-2.2 days vs. Group B 135.3+/-33.9 min, 2.9+/-0.8 mg/dL, 6.1+/-2.1 days, 9.4+/-3.7 days, p<0.05 respectively) Recurrent pelvic organ prolapse developed in 14.5% in group A and 12.5% in group B. Six patients (7.2%) in group A and 5 patients (6.9%) in group B required repeat operation for recurrent pelvic organ prolapse. CONCLUSIONS: Sacrospinous colpopexy without hysterectomy and with hysterectomy are equally effective surgical operation for uterine prolapse. This study shows that hysterectomy is not essential for the correction of uterine prolapse.
Subject(s)
Female , Humans , Catheters , Hysterectomy , Inpatients , Ligaments , Pelvic Organ Prolapse , Retrospective Studies , Uterine ProlapseABSTRACT
OBJECTIVE: To evaluate the efficiency and fetal outcome following antepartum transabdominal amnioinfusion in various causes of oligohydramnios. MATERIALS AND METHODS: Forty four transabdominal amnioinfusion were performed in twenty seven cases of singleton pregnancy with severe oligohydramnios. Severe oligohyadrmnios defined as amnionic fliud index of 5cm or less than. In all cases, high resolution sonographies were done before and after amnioinfusion in order to detect fetal anomalies. Transabdominal amnioinfusion was performed through a closed system with warmed normal saline. RESULTS: Infusion (mean volume 435.9ml) of normal saline significantly increased the amniotic fluid index from 3.2cm to 7.5cm. The causes of oligohydramnios were as follows, premature rupture of membranes was 8 cases (29.6%), intrauterine growth restriction was 10 cases (37.0%), congenital anomaly was 4 cases (14.8%) and idiopathic was 5 cases (18.5%). The gestational weeks were prolonged significantly from 26.8 weeks to 29.5 weeks. The overall survival rate except congenital anomalies was 67%. Babies with idiopathic oligohydramnios were heavier and required less hospitalization dates than those of badies with oligohydramnios of other causes, but it was not statistically significant. There were several complications as follows, chorioamnionitis 2 cases, neonatal sepsis 2 cases, meconium aspiration syndrome 2 cases and fetal bradycardia 1 case. All of the babies discharged healthy without sequele. CONCLUSION: These results show that antepartum transabdominal amnioinfusion is a relatively safe procedure. And it can significantly increase the amnionic fluid index and prolong the gestational age which is optimal for neonatal survival in oligohydramnios of idiopathic cause or with intrauterine growth restriction.
Subject(s)
Female , Infant, Newborn , Pregnancy , Amnion , Amniotic Fluid , Bradycardia , Chorioamnionitis , Gestational Age , Hospitalization , Meconium Aspiration Syndrome , Membranes , Oligohydramnios , Rupture , Sepsis , Survival RateABSTRACT
No abstract available.