RESUMEN
OBJECTIVE: To find out whether there is considerable influence on second trimester serum concentrations owing to the rhesus status. STUDY DESIGN: This retrospective cohort study was performed at the Perinatology Unit of the GATA Haydarpasa Teaching Hospital. During the study interval, 2265 pregnancies met inclusion criteria. The blood samples were collected in 117 pregnancies with a maternal rhesus-negative blood group status. The control group consisted of 2148 pregnancies with a maternal rhesus-positive blood group status. Statistical analysis was performed by SPSS 11.0 statistical software. RESULTS: Pregnancies with a maternal rhesus-negative blood group status were identified in 117 patients. The overall prevalence of pregnancies with a maternal rhesus-negative blood group status were 5.1% in our study. Only unconjugated estriol multiples of the median values were significantly decreased in rhesus-negative women (P<0.001). Alpha-fetoprotein and human chorionic gonadotrophin multiples of the median values did not differ significantly (P>0.05). CONCLUSION: We conclude that if second trimester screening test to be used in Rh negative pregnancies, either the corrected value should be referred or double test result should be considered ignoring the unconjugated estriol result. Another option is the first trimester Down syndrome screening test.
Asunto(s)
Síndrome de Down/diagnóstico , Tamizaje Masivo , Diagnóstico Prenatal , Isoinmunización Rh/diagnóstico , Adulto , Gonadotropina Coriónica/sangre , Síndrome de Down/epidemiología , Síndrome de Down/prevención & control , Estriol/sangre , Femenino , Humanos , Recién Nacido , Valor Predictivo de las Pruebas , Embarazo , Valores de Referencia , Isoinmunización Rh/sangre , Isoinmunización Rh/epidemiología , Turquía , alfa-Fetoproteínas/metabolismoRESUMEN
OBJECTIVE: To determine the efficiency and comparison of two different protocols, human menopausal gonadotropin (hMG) plus gonadotropin-releasing hormone analog (GnRH-a) and low-dose hMG to reduce multifollicular development in clomiphene-resistant polycystic ovary syndrome (PCOS) patients. STUDY DESIGN: Prospective comparative and pilot study in 20 patients for 31 cycles. The first group (n = 10) was treated with buserelin acetate, 600 micrograms/d, for six weeks before ovulation induction with hMG in conventional doses for 14 cycles. The other group (n = 10) was treated only with low-dose hMG for 17 cycles. All cycles were compared in terms of the number of follicles per cycle, cycles human chorionic gonadotropin withheld, estradiol level on ovulation day, treatment duration and number of ampules used per cycle. In addition, the outcome of cycles and complications of multifollicular development, ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy were determined. RESULTS: As compared with the GnRH-a + hMG protocol, the low-dose hMG protocol yielded less multifollicular (57.1% vs. 17.6%) and more monofollicular (35.7% vs. 70.6%) development. Consequently, less OHSS (21.4% vs. 0%) and multiple pregnancy (10% vs. 0%) occurred in the low-dose group. CONCLUSION: Low-dose hMG therapy has distinct advantages in eliminating multifollicular development and related complications in clomiphene citrate-resistant PCOS patients. The addition of GnRH-a to gonadotropins does not change the incidence of multifollicular development.
Asunto(s)
Clomifeno/farmacología , Fármacos para la Fertilidad Femenina/farmacología , Hormona Liberadora de Gonadotropina/uso terapéutico , Menotropinas/uso terapéutico , Folículo Ovárico/efectos de los fármacos , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Adulto , Anovulación/etiología , Anovulación/terapia , Relación Dosis-Respuesta a Droga , Resistencia a Medicamentos , Femenino , Hormona Liberadora de Gonadotropina/administración & dosificación , Hormona Liberadora de Gonadotropina/análogos & derivados , Humanos , Infertilidad/etiología , Infertilidad/terapia , Menotropinas/administración & dosificación , Folículo Ovárico/patología , Inducción de la Ovulación , Proyectos Piloto , Estudios ProspectivosRESUMEN
We describe the color Doppler sonographic features of uterine arteriovenous malformations in two cases. In both cases color Doppler imaging demonstrated hypervascularity throughout the arteriovenous malformation. The dominance of pale shades during both systole and diastole represented low-impedance, high-velocity flow within the lesion and a colored mosaic pattern representing turbulent flow was noted. Spectral analysis of the vessels within the lesion confirmed high-velocity flow during both systole and diastole, and a low resistance index. The spectral waveform trace also showed spectral broadening consistent with turbulence and the spectral envelope was irregular. These findings indicated the presence of numerous arteriovenous shunts and marked turbulence within the arteriovenous malformation. Spectral analysis of the venous flow revealed high flow velocities and systolic velocity peaks similar to an arterial pattern. The uterine artery velocity waveforms were characterized by high flow velocity and a low resistance index. The diagnosis of uterine arteriovenous malformation was confirmed by histological examination in both cases. The findings of these two cases suggest that color Doppler sonography may play an important role in the diagnosis of uterine arteriovenous malformations.