Hematological parameters of the mother and neonatal status during normal labor.

This study reviews the relationship between hematological parameters of the mother and the newborns status. Our material consisted of 180 pregnant women with singleton pregnancies who had an uncomplicated vaginal delivery. A negative relationship was noted between the pH and the maternal hemoglobin values both in the umbilical artery and vein (r = -0.27, p < 0.001, for the umbilical vein and r = -0.32, p < 0.0001, for the umbilical artery). A negative relationship was also noted between the umbilical vein pH and the maternal hematocrit, which was statistically significant (r = -0.28, p = 0.001). A similar negative correlation was observed between the umbilical artery pH and the maternal hematocrit (r = -0.32, p < 0.0001). In conclusion, maternal hematological parameters (hemoglobin, hematocrit) can affect the fetal acid-base balance.

Prostaglandin F1a and prostaglandin E2 plasma levels after transvaginal cervical cerclage.

Plasma prostaglandin metabolites, prostaglandin F1a (PGF1a) and prostaglandin E2 (PGE2) were measured in a serial set of maternal serum samples by radioimmunoassay after elective transvaginal cervical cerclage (Shirodkar) in 18 patients early in the 2nd trimester (14-15 weeks of gestation) for a history of cervical incompetence. Eight patients received progesterone preoperatively as a myometrial suppressant. The basal PGF1a and PGE2 were 134.0 +/- 25.9 pg/ml and 14.9 +/- 1.8 pg/ml, respectively. A gradual rise in both metabolites was observed within 1 hour after the operation (206.81 +/- 48.3 pg/ml and 16.7 +/- 1.6 pg/ml, respectively, p > .05), peaking at 6 hours (265.4 +/- 51.8 pg/ml, p < .01 and 25.9 +/- 4.9 pg/ml, p < .05), and falling to basal levels within 24 hours (136.7 +/- 26.5 pg/ml and 14.0 +/- 1.2 pg/ml, respectively, p > .05). The increase in PGF1a was proportionately greater than PGE2 metabolite (r = 0.838, p < .001). No differences were found in prostaglandin levels amongst patients who received progesterone as compared to the non-recipients for all the time intervals studied (p < .05). Our findings, further suggest that a temporary increase in prostaglandin production occurs following cervical cerclage, but its role remains unclear.

Genuine stress incontinence: prospective randomized comparison of two operative methods.

Eighty-one women with clinical and urodynamic findings of genuine stress incontinence and genital prolapse were randomly selected to be surgically treated with either anterior colporrhaphy or Burch colposuspension. Each patient had a complete clinical and urodynamic evaluation before surgery and at 2 months and 3 years after surgery. Differences in cure rates between the two procedures at the 2-month post-operative evaluation were insignificant; however, at the 3-year post-surgical evaluation, the cure rate of women who had undergone Burch colposuspension was significantly higher than that of women who had undergone anterior colporrhaphy (cure rates were 88% and 57%, respectively; P < 0.001). The Burch colposuspension was more effective than the anterior colporrhaphy in the stabilization of the bladder base, neck and proximal urethra as confirmed by transvaginal sonography. Post-operative spontaneous voiding was uneventful in both procedures. Results of this study demonstrate that the Burch colposuspension in our hands was more effective in treating genuine stress incontinence and pelvic relaxation than was anterior colporrhaphy.

Controlled ovarian hyperstimulation with or without intrauterine insemination for the treatment of unexplained infertility.

OBJECTIVE: To evaluate whether there are any benefits from intrauterine insemination (IUI) as opposed to timed intercourse (TI) in stimulated ovarian cycles in couples with longstanding, unexplained infertility. METHODS: Forty-six couples with diagnoses of unexplained infertility were evaluated in a crossover study after a total of 141 cycles. Sixty-seven cycles were with IUI after controlled ovarian hyperstimulation (COH) while 74 cycles were after COH and TI. RESULTS: The pregnancy rate after COH/TI was 16.7% and after COH/IUI 45.2%. Cycle fecundity however was 8.9% after COH/TI and 25.7% after COH/IUI, which is a statistically significant difference (P < 0.05). CONCLUSIONS: A trial of human menopausal gonadotropin and IUI is justified in couples with prolonged infertility of unknown cause.