Long-Term Results of an Imperforate Hymen Procedure that Leaves the Hymen Intact.

PURPOSE OF THE STUDY: The aim of this study was to show the clinical results of postoperative evaluation of cases of imperforate hymen that presented at our center during a 21-year period. METHODS: A Foley's catheter was inserted in 74 patients of imperforate hymen who reported to the Department of Obstetrics and Gynecology, Meram Faculty of Medicine, Necmettin Erbakan University, between January 1, 1996, and December 31, 2016 with history of pelvic pain. In each case, the hymen was opened via a circular incision from the central of the distended. A Foley's catheter was inserted, and estrogen cream was prescribed for application on the hymenal structure for 14 days. The catheter was removed after 14 days. RESULTS: The mean age of the patients at the time of this study was 28.3 ± 2.6 years, and the mean age at diagnosis was 13.2 ± 2.5 years. Twenty-nine (96.6%) patients had experienced vaginal bleeding during their first sexual intercourse experience, and one patient (3.4%) had not. Fourteen out of the 30 married women had become pregnant, of whom nine had delivered vaginally and five had delivered via a cesarean section. After undergoing renal ultrasound, none of the patients had any apparent anomalies. Only one patient had a uterine anomaly, which was a bicornuate uterus. CONCLUSION: A circular incision with insertion of Foley's catheter prevents many social problems by preserving the hymen's architecture and allowing vaginal bleeding to occur during the first sexual intercourse experience.

Is there a relationship between early pregnancy loss and maternal serum human X-box binding protein 1 level?

The human X-box binding protein 1 is a transcription factor that is expressed by cellular oxidative stress. We aimed to analyze the relationship between early pregnancy loss and maternal blood X-box binding protein 1 levels. Patients who presented to our Obstetrics and Gynecology clinic between October 2019 and February 2020 were included in this study. Patients were divided into two groups: Group 1 included healthy pregnant women and Group 2 included patients who were diagnosed with missed abortion. First, blood samples were taken from the patients in group 2 when they were diagnosed with missed abortion. While evaluating the patients in group 1, the average gestational weeks of the patients in group 1 were calculated and blood samples were taken between the same weeks. Next, patients with healthy pregnancy in group 1 were followed up prospectively and double screening test were performed at the perinatology outpatient clinic at the end of the 1st trimester, and the blood results of the patients with normal results were evaluated. Blood samples extracted from these patients were centrifuged at -80 °C and stored until analyses. Serum X-box binding protein 1 levels were measured using enzyme-linked immunosorbent assay kits (Cusabio, Wuhan, China). Eighty-five patients were included in this study: 42 in Group 1 and 43 in Group 2. There was no difference between the groups in terms of age, body mass index, ethnicity, and systemic illness. Serum X-box binding protein 1 levels were significantly higher in Group 2 (129.89 ± 7.58 ng/L) than in Group 1 (119.56 ± 5.99 ng/L) (p < 0.001). Serum X-box binding protein 1 levels higher than the cut-off value of 119.05 ng/L were associated with a higher risk of early pregnancy loss. Serum X-box binding protein 1 levels may be used to predict early pregnancy loss; however, additional comparative studies are required to confirm this result.

Conservative management of placental invasion anomalies with an intracavitary suture technique.

OBJECTIVE: To assess the efficacy and safety of a new surgical suture technique for uterine preservation among patients with placental invasion anomalies. METHODS: The present prospective case series included women diagnosed with placental invasion anomalies undergoing cesarean deliveries who desired future fertility at the obstetrics department of a Turkish university hospital between January 10, 2013, and April 20, 2017. Patients were diagnosed with ultrasonography and Doppler ultrasonography; the type of placental invasion anomaly (placenta accreta, increta, or percreta) was confirmed intraoperatively. Surgical management involved an intracavitary suture technique after the proximal branch of the uterine artery was clamped and utero-ovarian anastomoses had been blocked. Outcomes included units of blood transfused, intraoperative and postoperative adverse events, duration of hospital admission, and hysterectomy rate. RESULTS: There were 62 patients included. The mean operative blood loss was 1350 ± 750 mL (range 600-5000 mL). Blood transfusion required a mean of four units (range 2-15). Bleeding was controlled with the intracavitary sutures in 58 (94%) patients. Three patients experienced postoperative wound infections and two patients developed endometritis that required therapy with broad-spectrum antibiotics. The mean length of hospital stay was 3.6 ± 1.6 days (range 2-11). None of the patients required reoperation after the initial surgery. CONCLUSION: The novel uterus-sparing suture technique was highly effective among patients with placental invasion anomalies.