Clinical Characteristics and Outcomes of Laparoscopic Surgery in Ovarian Endometrioma Cases Treated at a Gynecology Clinic.

OBJECTIVES: The aim of this study was to retrospectively investigate the clinical and surgical outcomes of patients diagnosed with ovarian endometrioma in a hospital gynecology clinic and to investigate the safety and efficacy of treatment with laparoscopic surgery. METHODS: The data of 44 patients who were operated on for ovarian endometrioma were analyzed retrospectively. RESULTS: The mean age of the patients was 30.1±5.3 years. The mean cyst size was 7.0±5.3 cm. In all, 54% of the patients had dysmenorrhea, and 29.5% of the patients were infertile. Laparoscopy was successfully performed in all of the patients, and no complications were observed in any patient. Furthermore, it was found that ovarian reserve tests in the infertile patients were not negatively affected. CONCLUSION: With sufficient experience, laparoscopy is a very safe and effective method of surgery in ovarian endometrioma. If a laparoscopic cystectomy is performed with the proper technique, it does not adversely affect ovarian reserve.

Influence of placental cord drainage in management of the third stage of labor: a multicenter randomized controlled study.

OBJECTIVE: The aim of this study is to assess the effect of placental drainage during active management of the third stage of labor on reducing both blood loss and the length of the third stage. STUDY DESIGN: This prospective randomized controlled trial included 485 patients who underwent vaginal delivery in two tertiary hospital. Subjects were randomly allocated to the cord drainage group, in which the cord was unclamped after cutting (n = 242), or the control group, in which the cord was left clamped (n = 243). The primary outcome was mean blood loss during the third and fourth stages of labor. RESULTS: The mean estimated blood loss was significantly lower in the cord drainage group than in the control group (207.04 ± 123.3 vs. 277.63 ± 246.9 mL, respectively; p ˂ 0.001). The third stage of labor was significantly shorter in the cord drainage group than in the control group (3.5 ± 1.9 vs. 7.7 ± 3.4 minutes, respectively; p ˂ 0.001). No adverse events occurred during the cord drainage period. CONCLUSION: Active management of the third stage of labor with the cord drainage method significantly reduced postpartum blood loss and the duration of the third stage.

Unintended extension of the lower segment uterine incision at cesarean delivery: a randomized comparison of sharp versus blunt techniques.

OBJECTIVE: This study compared two methods of expanding the uterine incision at the time of cesarean delivery, which is associated with the risk of unintended extension. STUDY DESIGN: This randomized trial included 1,076 women who underwent elective cesarean delivery. The primary outcome measure was the incidence of unintended extension related to the method used for expanding the uterine incision. RESULTS: Participants in both groups (blunt vs. sharp) had similar demographic and clinical characteristics. The incidence of unintended extension (8.8% vs. 4.8%; p = 0.009), mean estimated blood loss (853.67 ± 42 mL vs. 664.80 ± 38 mL; p = 0.001), and blood loss >1000 mL (11.4% vs. 6.8%; p = 0.009) was significantly higher in the sharp group compared with the blunt group. No difference in transfusions (7.5% vs. 6.3%; p = 0.440) or the need for additional supertonic agents (16% vs. 12.9%; p = 0.144) was noted. CONCLUSION: Sharp expansion of the uterine incision was related to a higher risk of unintended extension and maternal blood loss. Because blunt expansion is associated with a lower risk for unintended extension and maternal blood loss, it should be the first option during elective cesarean delivery.