Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 17 de 17
Filter
1.
Clin Exp Obstet Gynecol ; 31(1): 53-5, 2004.
Article in English | MEDLINE | ID: mdl-14998190

ABSTRACT

OBJECTIVE: To improve perinatal survival rates by prolonging the rest of the pregnancy after an abortion or extremely premature birth of one fetus in multiple pregnancies, especially in women with low fertility potential. METHODS: Following the expulsion of one fetus a cervical cerclage was applied to all patients. The placenta of the expelled fetus including a small portion of its cord after it was ligated close to the external os, was left in situ. The patients were invariably kept on bed rest until the pregnancy was completed under close observation, tocolysis and preventive antibiosis. After the 24th week of gestation corticosteroids were administered. RESULTS: The delivery interval achieved ranged between two and 135 days, the longest reported. Although the survival rate was relatively low (40%) all but one of the women (83%) managed eventually to have a live child, one with twins. CONCLUSIONS: In selected multiple pregnancies the attempt to prolong the rest or the pregnancy, following the abortion or the extremely premature birth of one fetus, seems efficacious and justified especially in women with a history of long-term infertility.


Subject(s)
Abortion, Spontaneous/prevention & control , Cerclage, Cervical , Pregnancy, Multiple , Adult , Female , Fetal Death , Humans , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Pregnancy , Triplets , Twins
2.
Clin Exp Obstet Gynecol ; 29(4): 267-70, 2002.
Article in English | MEDLINE | ID: mdl-12635742

ABSTRACT

The purpose of this prospective preliminary clinical study was to assess the efficacy of thromboprophylaxis throughout pregnancy in women with a history of unexplained first trimester recurrent miscarriages. From the 53 patients originally assigned to the study 15 were excluded. The remaining 38 were treated with low molecular weight heparin (LMWH-natroparine calcium 0.3 ml twice daily) and low dose aspirin from the day the fetal heart motion was detected until the 37th week or earlier at the onset of premature labor. Among the patients treated (n = 38) thrombophilia screening was positive in 16 patients and in the remaining 22 no causative factor was detected. The overall success rate (viable pregnancy > or = 24 weeks) was 92.2% with no significant difference between patients with positive or negative thrombophilia screening. The most significant complications were: preeclampsia (21%), IUGR (26%), placenta abruptio (5.2%), injection site haematoma (44%) and skin reaction (15.7%). No abnormal bleeding was observed during vaginal or caesarean section. The results of this study suggest that thromboprophylaxis during pregnancy, which has already been successfully tried in patients with recurrent miscarriages with a causative factor, may be similarly effective in patients with such a pregnancy complication but of unknown aetiology.


Subject(s)
Abortion, Habitual/prevention & control , Anticoagulants/therapeutic use , Aspirin/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Pregnancy Complications, Hematologic/prevention & control , Thrombophilia/prevention & control , Adult , Anticoagulants/administration & dosage , Aspirin/administration & dosage , Cohort Studies , Drug Administration Schedule , Female , Heparin, Low-Molecular-Weight/administration & dosage , Humans , Pregnancy , Pregnancy Trimester, First , Prospective Studies , Treatment Outcome
3.
Eur J Obstet Gynecol Reprod Biol ; 89(1): 15-7, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10733018

ABSTRACT

OBJECTIVE: The purpose of our study was to evaluate factors that may predispose to rupture of tubal ectopic pregnancy. The study included 99 cases of ectopic pregnancies that were treated during the 5-year period 1992-1996. RESULTS: It was found that: (1) tubal rupture is encountered more often in women with no history of ectopic pregnancy and in those who have full-term pregnancy, suggesting that ectopic pregnancy is less suspected in these women; (2) tubal rupture is encountered less often in lower age ectopic pregnancy; and (3) serum beta-hCG level does not predict tubal rupture. CONCLUSIONS: Rupture of the tube is more often observed in women with a history of ectopic pregnancy and in women with full-term pregnancy. Such observations suggest that ectopic pregnancy is less suspect in these cases.


Subject(s)
Fallopian Tube Diseases/etiology , Pregnancy, Tubal , Adult , Aging , Chorionic Gonadotropin, beta Subunit, Human/blood , Female , Gestational Age , Humans , Pregnancy , Recurrence , Risk Factors , Rupture, Spontaneous
4.
J Matern Fetal Med ; 9(5): 298-302, 2000.
Article in English | MEDLINE | ID: mdl-11132587

ABSTRACT

OBJECTIVE: To test the hypothesis that the circulating levels of leptin in the maternal and cord serum correlate with the birthweight of the newborns and with the weight of the placenta. METHODS: In a population of 85 women from northern Greece who gave birth to an equal number of full-term infants, we calculated the concentration of leptin in the maternal serum as well as in the cord serum, right after delivery, by using an immunoradiometric assay. The correlation between these values, the maternal BMI before pregnancy and at the time of delivery, the neonatal BMI, Ponderal Index, and the placental weight was studied. RESULTS: Mean maternal leptin showed a statistically significant difference from mean cord serum leptin (14.7 and 7.07 ng/ml, respectively) and was positively correlated to the maternal BMI at the time of delivery (r = 0.3, P = 0.016), but not to neonatal BMI. A positive correlation between the mean cord serum leptin and the BMI of the neonates (r = 0.26, P = 0.031 ) was found. There was no correlation between the maternal BMI at the time of delivery and the neonatal BMI. Similarly, no correlation could be established between the placental weight and the levels of leptin in the maternal or in the cord serum but a positive correlation between placental weight, neonatal BMI and weight, and mothers' BMI was observed. Finally, although a noteworthy difference between the mean leptin levels of neonates of two different sexes was observed (male 5.9 ng/ml, female 7.8 ng/ml), that difference never reached a statistically significant level. CONCLUSIONS: The maternal leptin level could not be used as a reliable marker of fetal growth but a positive correlation between cord serum leptin and fetus growth is suggested.


Subject(s)
Embryonic and Fetal Development , Fetal Blood/chemistry , Leptin/blood , Placenta/anatomy & histology , Adult , Birth Weight , Body Mass Index , Female , Humans , Infant, Newborn , Organ Size , Pregnancy
5.
J Obstet Gynaecol ; 20(2): 188-9, 2000 Mar.
Article in English | MEDLINE | ID: mdl-15512516
6.
J Obstet Gynaecol ; 20(6): 618-9, 2000 Nov.
Article in English | MEDLINE | ID: mdl-15512679

ABSTRACT

The aim of this study was to estimate the percentage of women who asked for pregnancy termination as an alternative to using family planning. The reasons given for requesting termination were documented and evaluated. During a 4-year period, 663 women came to the Family Planning Department. Four hundred and ninety-one (77.6%) were pregnant, in the first trimester of pregnancy and requesting an induced abortion. Consultation and counselling resulted in a 25% decrease in the number who finally had their pregnancies terminated. The low socio-economic status of most of the women and the negative attitude of our society towards an unmarried mother remain the main reasons for a high rate of therapeutic abortion.

7.
Fertil Steril ; 71(6): 1010-3, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10360902

ABSTRACT

OBJECTIVE: To evaluate the limits of the conservative management of relatively advanced ectopic pregnancies (EPs) with local methotrexate given at a higher than standard dose. DESIGN: Nonrandomized prospective study. SETTING: A tertiary teaching hospital and an affiliated infertility center. PATIENT(S): We treated 118 EPs of up to 56 days' gestation (8 weeks) regardless of the presence of fetal heart activity, the size of the gestational mass, and the initial beta-hCG levels. INTERVENTION(S): Transvaginal intraamniotic or laparoscopic intratubal injection of 100 mg of methotrexate as a single dose. MAIN OUTCOME MEASURE(S): beta-hCG levels, red and white blood cell count, and liver function tests before and after methotrexate injection, followed by repeat transvaginal color Doppler assessments. RESULT(S): Treatment was successful in 105 (88.98%) of the 118 patients included in the study. In 7 of them with persistent fetal cardiac activity after the methotrexate injection, treatment was concluded with a complementary intracardiac injection of 10% KCl. No grade 3 or important clinical, hematologic, or biochemical toxicities occurred. CONCLUSION(S): Local administration of a single high dose of methotrexate (100 mg) proved safe and effective in the medical management of relatively advanced and unselected EPs, including cases with fetal heart activity, with high initial beta-hCG levels, and with a gestational mass beyond the standard maximum of 3.5 cm. Complementary hypertonic KCl proved to be effective in cases with persistent cardiac activity.


Subject(s)
Methotrexate/administration & dosage , Pregnancy, Ectopic/drug therapy , Adult , Amnion/drug effects , Chorionic Gonadotropin, beta Subunit, Human/blood , Erythrocyte Count , Fallopian Tube Patency Tests , Female , Gestational Age , Humans , Leukocyte Count , Liver Function Tests , Methotrexate/adverse effects , Methotrexate/therapeutic use , Pregnancy , Pregnancy, Ectopic/diagnostic imaging , Pregnancy, Ectopic/physiopathology , Prospective Studies , Treatment Outcome , Ultrasonography
8.
Arch Gynecol Obstet ; 262(1-2): 53-7, 1998.
Article in English | MEDLINE | ID: mdl-9836000

ABSTRACT

The study was conducted to establish a correlation between Doppler velocimetry in relation to uterine weight in any phase of the menstrual cycle and symptoms in women who have leiomyomas. Doppler velocimetry was carried out on both uterine arteries in 18 pre-menopausal women and one post-menopausal woman prior to undergoing abdominal hysterectomy at Winthrop University Hospital in Mineola, NY and at Ioannina University Hospital. The t-test was used for statistical analysis. Changes in flow velocity correlated directly with uterine size. When a division at 500 g was used, S/D ratio was 2.74 +/- 0.53 for larger uteri vs. 4.2 +/- 1.24 for smaller uteri, p < 0.006. Eight women presented heavy bleeding and the mean S/D ratio was 3.75 +/- 1.36 while eleven women presented mild bleeding and the mean S/D ratio was 3.51 +/- 1.2 (p > 0.5). Thus the study has demonstrated that in cases of uterine leiomyomas, the uterine artery flow increases although angiography had previously shown decreased vascularity within the tumor.


Subject(s)
Arteries/physiopathology , Laser-Doppler Flowmetry , Leiomyoma/physiopathology , Uterine Neoplasms/physiopathology , Uterus/blood supply , Female , Humans , Organ Size , Uterus/pathology
9.
Int J Fertil Womens Med ; 43(3): 159-64, 1998.
Article in English | MEDLINE | ID: mdl-9692539

ABSTRACT

DESIGN: Two new indices, the sperm deformity index and the multiple anomalies index, were evaluated in order to help identify fertile and infertile semen. RESULTS: It was found that only three out of 94 infertile men presented a sperm deformity index lower than the upper limits of normal. The sperm deformity index sensitivity and specificity were higher than those of the multiple anomalies index. CONCLUSION: The sperm deformity index is a reliable predictor in the identification of fertile and infertile semen, and therefore can help in the selection of patients who require assisted reproduction techniques.


Subject(s)
Infertility, Male/diagnosis , Spermatozoa/abnormalities , Adult , Fertility , Humans , Male , Middle Aged , ROC Curve , Reproducibility of Results , Semen/cytology , Sensitivity and Specificity
10.
J Obstet Gynaecol ; 18(6): 581-3, 1998 Nov.
Article in English | MEDLINE | ID: mdl-15512185

ABSTRACT

Headless or unucleated spermatozoa were evaluated in semen specimens of 52 fertile men in order to investigate the frequency and the percentage of this morphological abnormality and to estimate the probable correlation of the abnormality with other semen parameters, since there are no available data. The only sperm parameter which correlated with the number of headless spermatozoa was the number of micro round-headed spermatozoa (r= + 0.4432, P<0.001). It is concluded that the high frequency of headless or unucleated spermatozoa in the semen specimens of fertile men, albeit in low percentage, does not seem to have any biological significance. Moreover headless and round-headed spermatozoa could be the outcome of the same pathogenetic mechanism.

11.
Arch Androl ; 39(3): 237-42, 1997.
Article in English | MEDLINE | ID: mdl-9352036

ABSTRACT

Hyperprolactinemia in man decreases libido and potency, but the few reports concerning its influence on spermatogenesis are contradictory. The aim of this study was to evaluate the effect of induced hyperprolactimemia on semen parameters. A total of 15 potentially fertile male volunteers, aged 28.2 +/- 4.3 years, were given 10 mg metoclopramide three times daily for 12 weeks. Serum and seminal plasma prolactin levels and semen parameters were determined before and 4, 8, and 12 weeks following initiation of metoclopramide administration. A fivefold increase of serum prolactin levels was observed, semen volume and abnormal sperm forms decreased, while spermatozoa velocity increased. On the contrary, no influence was noted on the number of spermatozoa per milliliter, the total number of spermatozoa, the percentage of motile spermatozoa, or the index of motility. Hyperprolactinemia seems to improve spermatozoal velocity and morphology, although direct effect of metoclopramide on these parameters cannot be excluded.


Subject(s)
Hyperprolactinemia/physiopathology , Semen , Adult , Humans , Hyperprolactinemia/blood , Hyperprolactinemia/chemically induced , Male , Metoclopramide , Prolactin/blood , Sperm Count , Sperm Motility
12.
Eur J Obstet Gynecol Reprod Biol ; 74(2): 127-31, 1997 Aug.
Article in English | MEDLINE | ID: mdl-9306104

ABSTRACT

beta-Thalassaemia major is a severe, transfusion-dependent anaemia that also causes infertility due to iron deposition to endocrine organs. Very few pregnancies have been reported among such patients. In this report we describe the evolution and successful outcome of pregnancy in 5 Greek women with beta-thalassaemia major. There were four full-term and one preterm deliveries of two normal and three small for the date neonates. Cardiovascular changes related to gestation may aggravate the underlying multiorgan damage of the pregnant mother and predispose to poor fetal growth and development. All five patients followed a strict transfusion regimen in order to maintain the haemoglobin level above 10 g/dl. The inadvertent administration of desferrioxamine in one patient until the 8th gestational week did not seem to have any serious effects on the development and well-being of the fetus. Although pregnancy is not contraindicated in beta-thalassaemia major, intensive individualized care is required if it is to be safe for the mother, and have a reasonably good chance of producing a healthy child.


Subject(s)
Homozygote , Pregnancy Complications, Hematologic/physiopathology , Pregnancy Outcome , beta-Thalassemia/physiopathology , Adult , Delivery, Obstetric/methods , Echocardiography , Erythrocyte Transfusion , Female , Follow-Up Studies , Humans , Pregnancy , Pregnancy Complications, Hematologic/therapy , beta-Thalassemia/therapy
13.
Am J Perinatol ; 13(2): 85-7, 1996 Feb.
Article in English | MEDLINE | ID: mdl-8672191

ABSTRACT

Umbilical cord blood erythropoietin levels and hematocrit are significantly higher in smoking mothers than those nonsmoking ones. In addition, the incidence of newborns with low birthweight is higher in women who smoke. We conclude that in addition to other parameters, cord blood erythropoietin might be used as a valuable indicator of fetal distress in smokers.


Subject(s)
Erythropoietin/blood , Fetal Blood/chemistry , Fetal Distress/blood , Pregnancy Complications/etiology , Smoking/adverse effects , Adult , Case-Control Studies , Female , Fetal Distress/diagnosis , Fetal Distress/etiology , Hematocrit , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Complications/diagnosis
14.
J Reprod Med ; 40(5): 409-14, 1995 May.
Article in English | MEDLINE | ID: mdl-7608889

ABSTRACT

Cervical pregnancy was diagnosed in a nulliparous, 28-year-old woman who presented with intermittent vaginal spotting at 12 weeks of gestation. Sonographic evaluation revealed a cervical gestational sac with a fetus with cardiac activity. Methotrexate was instilled intraamniotically, followed by an intramuscular injection with folinic acid rescue. On the seventh day of treatment an uneventful curettage was performed because of persistent fetal viability. Five months later pregnancy occurred. The patient vaginally delivered a healthy, 3,080-g neonate at 40 weeks of gestation. To our knowledge, only nine other cervical pregnancies have been managed medically with either methotrexate or etoposide. It seems that first-trimester cervical pregnancies, especially those at less than nine weeks of gestation, can be effectively treated with methotrexate. Successful medical therapy must be considered, not only for regression of the gestation but also for preservation of anatomic integrity and fertility. Four of the above patients, including ours, had a subsequent intrauterine pregnancy, and one of those pregnancies terminated in spontaneous abortion.


Subject(s)
Dilatation and Curettage , Methotrexate/therapeutic use , Pregnancy, Ectopic/therapy , Adult , Cervix Uteri , Chorionic Gonadotropin/blood , Female , Humans , Pregnancy , Pregnancy, Ectopic/blood
15.
Am J Perinatol ; 11(6): 427-9, 1994 Nov.
Article in English | MEDLINE | ID: mdl-7857436

ABSTRACT

In this study we determine the erythropoietin levels and hematocrit in 22 women with preterm labor, 21 with insulin-dependent diabetes, 22 with preeclampsia, and 20 with normal gestation. The erythropoietin level was higher in the preeclamptic group than in the diabetic group compared with the normal and premature groups. There were no hypoxic fetuses. From this study, we found that the mechanism of increased erythropoietin levels in neonates can be different from fetal hypoxia. Further studies are needed on this subject.


Subject(s)
Diabetes Mellitus, Type 1/blood , Erythropoietin/blood , Fetal Blood/chemistry , Obstetric Labor, Premature/blood , Pre-Eclampsia/blood , Pregnancy in Diabetics/blood , Adult , Birth Weight , Female , Humans , Pregnancy , Prospective Studies
17.
Am J Obstet Gynecol ; 162(5): 1225-9, 1990 May.
Article in English | MEDLINE | ID: mdl-2187352

ABSTRACT

Fifteen patients with polyhydramnios and clinical symptoms related to excess amniotic fluid volume were treated with indomethacin therapy that was started at a mean gestational age of 27.4 +/- 2.79 weeks and discontinued at a mean gestational age of 32.9 +/- 1.83 weeks. Patients were treated with 2.0 to 2.2 mg of indomethacin per kilogram of body weight per day, either orally or by rectal suppositories. No therapy was administered after 35 weeks, and the duration of therapy was no longer than 4 weeks. The majority of fluid reduction occurred within the first week of treatment. Subsequently, a smaller but steady reduction of fluid was observed. All patients were delivered after 38 weeks with a mean birth weight of 3543 +/- 586.3 gm. Examinations of newborns at birth and follow-up at 3 months, 6 months, and 1 year revealed no adverse effects of indomethacin administration.


Subject(s)
Indomethacin/therapeutic use , Polyhydramnios/drug therapy , Administration, Oral , Administration, Rectal , Adult , Amniotic Fluid/drug effects , Drug Evaluation , Female , Follow-Up Studies , Humans , Indomethacin/administration & dosage , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Second , Pregnancy Trimester, Third , Suppositories
SELECTION OF CITATIONS
SEARCH DETAIL
...