Progesterone effects on preterm birth in high-risk pregnancies: a randomized placebo-controlled trial.

PURPOSE: The purpose of this study was to evaluate whether the prophylactic administration of vaginal progesterone would reduce the preterm birth rate in high-risk population including singleton and twin pregnancies. METHODS: This was a randomized, double blind, placebo-controlled study that included 150 high-risk pregnancies. Risk groups included prior spontaneous preterm birth, twin pregnancy, and uterine malformation. Micronized progesterone or placebo (100 mg) was administered daily by vaginal suppository between 24 and 34 weeks of gestation. We compared progesterone and placebo groups for incidence of preterm labor and preterm delivery. Data were compared by χ² analysis and Fisher exact test. RESULTS: There was a statistically significant difference in the rate of preterm labor between placebo and progesterone groups (45.7 vs. 25%, respectively; p < 0.05). More women delivered before 37 weeks in placebo group (57.2%) than in progesterone group (40%; p < 0.05). Administering progesterone also reduced the preterm birth before 34 weeks of gestation. The difference between placebo and progesterone group was statistically significant (24.3 vs. 8.8%; p < 0.05). However, there was no significant difference in neonatal death between placebo and progesterone groups. CONCLUSION: Prophylactic vaginal progesterone reduced the rate of preterm labor and preterm delivery in high-risk pregnancies.

Validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in a Turkish population.

OBJECTIVE: To validate the Turkish translated version of short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). STUDY DESIGN: After the test-retest reliability and internal consistency were established in a pilot study, 270 patients were enrolled and general and subscale scores of the questionnaire were calculated. All participants underwent the International Continence Society (ICS) prolapse score (POP-Q) and urodynamic assessment. Main scores and scores of Prolapse Quality of Life questionnaire (PQoL) and Incontinence Impact Questionnaire (IIQ-7) were compared between patients with incontinence+/-prolapse and asymptomatic women. RESULTS: 62.24% of the participants showed urodynamic abnormality and/or leakage with or without prolapse. 28.91% had prolapse stage 3 or higher diagnosed by the POP-Q system. PISQ-12 showed a high internal consistency (Cronbach's alpha was 0.89). For test-retest reliability Spearman's rho was 0.72-0.79 for all domains. The mean scores of PISQ-12 were significantly better in asymptomatic women compared with the incontinence+/-prolapse group. Sexual function was negatively affected by prolapse and/or incontinence as assessed with PQoL and IIQ-7 questionnaires. CONCLUSION: The Turkish translated version of the PISQ-12 is a reliable, consistent and valid instrument to evaluate sexual functioning in women with urinary incontinence and/or pelvic organ prolapse. It is easy to understand that it may be easily administered and self-completed by the women.

Inguinal herniorrhaphy in childhood may result in tubal damage and future infertility.

INTRODUCTION: Inguinal hernias commonly occur during infancy. They are approximately six times more common in males than in females. They are one of the most common surgical conditions in childhood. About 5-20% of inguinal hernias have the ovary or fallopian tube in the hernia sac. Surgical interventions during childhood may cause damage. Unawareness of this damage can cause infertility in future. CASE REPORT: Presentation of a case diagnosed as having tubal damage during laparoscopic operation because of primary infertility with a history of inguinal hernia during her childhood. Inguinal hernia repair caused tubal damage and bilateral tubal occlusion as a cause of primary infertility. CONCLUSION: Medical history is of great importance during infertility investigation and may reveal some unexpected conditions.