ABSTRACT
BACKGROUND: Many couples fail to achieve pregnancy instead repeated FIV-TE-ICSI cycles. Good quality embryos for successful pregnancy rates should not be count apart over endometrial receptivity. OBJECTIVE: To assess the impact of office hysteroscopy in a group of patients with two or more previous failed cycles of FIV-TE-ICSI in an assisted reproduction center. MATERIAL AND METHOD: Retrospective case control study in patients with problems to conceive in two or more previous failed FIV-TE-ICSI cycles instead good quality embryos and an apparently normal uterine cavity. They were divided in two groups: A with no hysteroscopy perfomed, and 8 with hysteroscopy. Second group was divided in 81 (without pathologic findings) and 82 (with intrauterine abnormalities). Demographic variables were analized, hysteroscopic findings, good quality embryos transferred, biochemical and clinical pregnancies and perinatal results in all groups. RESULTS: No significant differences were found in demographic variables analyzed among patient with or without office hysteroscopy. Intrauterine abnormalities were found in 16 (64%) patients of group 82. No significant statistical differences were found respect biochemical, clinical pregnancies or live birth new born. CONCLUSIONS: Instead previous diagnosis of an apparently normal uterine cavity, pathologic abnormalities were found in a significant number of patients. We observed an improvement in pregnancy rates in patients in with HC was realized previous to FIV-TE-ICSI, particularly on those were endometrial pathology was found and corrected, even though the study sample did not allowed to reach results with statistical difference.
Subject(s)
Embryo Transfer , Fertilization in Vitro , Hysteroscopy , Sperm Injections, Intracytoplasmic , Uterine Diseases/diagnosis , Adult , Awards and Prizes , Case-Control Studies , Embryo Implantation , Female , Gynecology , Humans , Infant, Newborn , Infertility, Female/etiology , Mexico , Obstetrics , Polyps/complications , Polyps/diagnosis , Polyps/surgery , Pregnancy , Pregnancy Rate , Pregnancy, Multiple , Retrospective Studies , Treatment Outcome , Uterine Diseases/complications , Uterine Diseases/therapyABSTRACT
The double twin pregnancy with complete hydatidiform mole and coexistent fetus is a rare event and perinatal treatment complex. Presents a significant case of this unusual partnership and describes their evolution. Patient of 33 years, secondary infertility factor-peritoneal tube and pregnancy achieved by in vitro fertilization and embryo transfer. An ultrasound early pregnancy reported twice, a sack was a complete mole, another bag was a fetus and placenta previa unchanged total. The case is carefully monitored and uterine inhibitors were administered at different stages of gestation. It settled the case by caesarean section at 37 weeks and obstetric hysterectomy for placenta previa percreta molar involution of the placenta and newborn health. The evolution of the mother and the child was appropriate.
Subject(s)
Diseases in Twins/etiology , Embryo Transfer/adverse effects , Fertilization in Vitro/adverse effects , Hydatidiform Mole/complications , Placenta Previa/etiology , Pregnancy, Multiple , Uterine Neoplasms/complications , Adult , Female , Humans , PregnancyABSTRACT
OBJECTIVE: To evaluate the secretion of interleukin 6 (IL-6) in cervicovaginal fluid in a pseudocohort that emulates the evolution of the labor. MATERIAL AND METHOD: Samples of cervicovaginal fluid of patients with 20 to 40 weeks of gestation were taken, patients were classified in 5 strata of the development of the labor. Each stratum reflects the progressive activation of the uterine activity and the cervical changes. To each sample was made determination of IL-6 by means of the system Multiplex. The samples of patient with infection data were eliminated. RESULTS: 173 samples were included distributed in each one of the five strata. Basal secretion exists of IL-6 to the cervicovaginal fluid along the gestation, that doesn't modify until the active labor appears. Only when the uterine activity is manifested in form to regulate and effective, very significant increase is documented in the concentration of the IL-6 in the cervicovaginal fluid. CONCLUSIONS: The IL-6 it is a proinflammatory cytokine that increases in a specific way in the moment in that the effective uterine activity begins, thus, it is an excellent candidate to be evaluated as marker presage of the event of normal labor and preterm.
Subject(s)
Exudates and Transudates/chemistry , Interleukin-6/analysis , Interleukin-6/metabolism , Labor, Obstetric/metabolism , Cervix Uteri , Female , Humans , Pregnancy , VaginaABSTRACT
Antecedentes: El síndrome hemofagocítico es un desorden caracterizado por una proliferación benigna de los histiocitos y la fagocitosis de las células hematopoiéticas normales. Puede ocurrir por diversos estados de compromiso inmunológico o secundario a una gran variedad de infecciones. El comportamiento clínico puede presentarse desde una rápida recuperación hasta la muerte. Caso: Se descubrió una aplasia hematopoiética en una mujer de 27 años con 22 semanas de gestación sin factores de riesgo conocidos, presentando signos y síntomas aparentes de un síndrome purpúrico. La serología viral confirmó IgG e IgM positivos para Erythrovirus B19 y el aspirado de médula ósea demostró una hemofagocitosis reactiva con histiocitos y blastos afectando línea celular roja y blanca. El cuidado materno-fetal y el manejo conllevó al nacimiento de un recién nacido sin complicaciones. Conclusión: El diagnóstico del síndrome hemofagocítico durante el embarazo y el manejo oportuno de las complicaciones resultó en una adecuada resolución y éxito perinatal.
Background: Hemophagocytic syndrome is a hematologic disorder characterized by benign proliferation of histiocytes that undergo uncontrolled phagocytosis of normal hematopoietic cells. It can occur as a consequence of immunologic compromise or secondary of a wide range of infections. Clinical behavior can present from complete recovery to rapid deterioration and death. Case: Hematopoietic aplasia was discovered in a 27-year-old pregnant woman, gravida 2, at 22 weeks' gestation without known risk factors, presenting signs and symptoms of a purpuric syndrome. Confirmatory IgG and IgM Erythrovirus B19 viral serology was reported and bone marrow aspírate demonstrated reactive hemophagocytosis with histiocytes and blasts affecting red and white blood cell lines. Maternal-fetal assessment and management resulted in the delivery of a healthy newborn with an uncomplicated postpartum response. Conclusion: Oportune diagnosis of hemophagocytic syndrome during pregnancy and prompt management of its complications result in a marked resolution and perinatal success.
