RESUMEN
In Saudi Arabia, road traffic crashes are becoming a serious public health problem and there are no recent, large-scale, published reports discussing maternal and fetal injuries. We aimed to explore the predictors of fetal death/abortion after maternal trauma. A retrospective case-control study was performed exploring cases of maternal trauma. The study group included 118 women with pregnancy loss while 308 women without loss represented the control group. All data were compared using univariate analysis followed by multivariate regression analysis. Only 3 predictors were associated with significant effect on pregnancy loss after trauma [P < 0.05]: second trimester of pregnancy [OR 2.77, 95% CI: 1.66-4.63, placental abruption [OR 3.69, 95% Cl: 2.01-6.79] and severe injury score [OR 6.78, 95% Cl: 4.04-11.37]
Asunto(s)
Humanos , Femenino , Accidentes de Tránsito/estadística & datos numéricos , Estudios Retrospectivos , Estudios de Casos y Controles , Mujeres Embarazadas , Heridas y Lesiones , Resultado del EmbarazoRESUMEN
The aim of this study was to compare the effects of combination of long acting GnRH agonist [Goserelin] and oral contraceptive [OC] therapy and laparoscopic ovarian cauterization on the endocrine changes in women with clomiphene citrate [CC] - resistant polycystic ovary disease [PCOD]. Twenty one women with CC- resistant PCOD were included randomly in the study to either laparoscopic ovarian cautery [n = 10] or GnRH-a and OC therapy for 3 months [n = 11]. Serum concentrations of LH, F.S.H, androstenedione [A], testosterone [T] and sex hormone binding globulin [SHBG] were determined in each group and during the follicular phase of first menstrual cycle after cessation of each treatment. Our results showed that the mean serum concentrations and clinical profiles were similar in both groups. Both groups showed significant decrease in LH, A and T and significant increase in FSH compared with pretreatment levels. The SHBG concentration increased in both groups after therapy, however, the increase was significant only in the goserelin and OC group. There were no significant difference in the final concentrations of LH, FSH and A between the two study groups after each treatment, whereas, T was significantly decreased and SHBG significantly increased in the goserelin and OC group. The ovulation rate after the cessation of either therapy was similar [8/10 versus 9/11, p > 0.05]. On the basis of our results, we conclude that despite similar endocrine effects, medical treatment with GnRH-a and OC may be more appropriate and effective in reversing the abnormal cascade in PCOD. Although both regimens have temporary and similar improvement on PCOD, the adhesion forming potential, invasiveness, cost and surgical complications of laparoscopic ovarian cauterization may enable GnRH-a and OC combination to be cost effective option in women with CC-resistant PCOD