Role of sonohystrography in checking caesarean section scars

Optimally performed hysterosalpingography and saline infusion sonohysterography can be relatively comfortable procedures for the patient that provide a great deal of useful diagnostic information. Thirty patients were divided into 2 groups: Group I [15 patients] had normal healthy uterine wall scar detected by hystroscopy, group 11[15 patients] had a uterine wall defect detected by hysteroscopy at the site of CS. Transvaginal sonohysterographic evaluation was done after slow intrauterine infusion of 10 to 20 ml of sterile isotonic saline. This results in a sensitivity of 93.33% specificity of 86.67%, positive predictive value of 87.5%, negative predictive value of 92.86% and an overall accuracy of 90% for sonohystrographic examination in diagnosing the presence of a uterine wall defect after CS. Transvaginal ultrasound holds promise as a useful tool for trying to answer important clinical questions in prospective trials

Urinary FSH versus recombinant FSH in clomiphene citrate-resistant anovulatory patients, effectiveness and cost-effectiveness

Recombinant FSH [r-FSH] and urinary FSH [u-FSH] have been repeatedly compared in trials dealing with superovulation induction for IVF. 50 women, suffering WHO group II anovulatory mntertmlity and clomiphene citrate resistance were included in this study. Patients were divided into 2 groups: Group I [u-FSH group, n:25] and Group II [r-FSH group, n:25]. Details of ovarian response, FSH dose used and duration of the 100 stimulation cycles are presented. r-FSH may result in a better outcome in IUI cycles for unexplained infertility, while urinary FSH performed better in older women than recombinant FSH when associated with the long protocol

Role of vaginal delivery after one previous caesarean section

Once a cesarean, always a cesarean" rule is not now the rule. 100 patients with history of previous one caesarean section done since more than one year for non-permanent indications were subjected to a trial of normal vaginal delivery. 70 NVD was done out of the 100 patients [70%]. After 1 year of CS for non permanent indications, trial of NVD is a must