Goserelin and oral contraceptive combination versus laparoscopic ovarian cauterization and their effects on the endocrine changes in women with clomiphene citrate resistant polycystic ovary disease

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

effect of iron deficiency anemia on placental weight and ratio

Placental weight and placental ratio [placental weight/birth weight] were determined in 500 women delivered in Obstetrics and Gynecology Department, Tanta University Hospital. Half of them with normal hemoglobin and mean corpuscular volume and 250 women with iron deficiency anemia [Hb <11 g/dl and MCV <80 fl]. It was observed that placental weight and ratio increased significantly in anemic group. The importance of this discordance of placental weight and birth weight was discussed

Complement 4 in pregnant hypertension with and without proteinuria

The objective of our study was to investigate the role of complement 4 [C[4]] in the pathogenesis of pre-eclampsia. The study was conducted on 30 women, 10 of whom were pregnant with proteinuric hypertension, 10 were pregnant with non-proteinuric hypetension and 10 normal pregnant women as a control group. Total plasma protein, serum albumin and serum complement 4 were estimated before delivery for all groups and 5 days after delivery for the proteinuric and non-proteinuric hypertension groups. The results revealed that in women with proteinuric hypertension antenatal C[4], total protein and albumin concentration were significantly less than those of their matched controls. On the other hand, the concentration of C[4], total protein and albumin in women with non-proteinuric hypertension were slightly lower but not significantly different from those of the control group. Five days after delivery there was significant increase in C[4] but not in total protein or albumin concentration in both hypertensive groups. So the decreased serum concentration of C[4] may participate in the pathogenesis of hypertension of pregnancy