RESUMEN
OBJECTIVE: To evaluate the outcomes and management options in pregnancies with early onset oligohydramnios. MATERIALS AND METHODS: The file datas of all pregnancies diagnosed as oligohydramnios or anhydramnios before 27 gestational weeks between January 2006 and September 2013 were evaluated retrospectively. The underlying pathology and associated anomalies, karyotype analysis, the outcome of the pregnancy (either termination or labour), and gestational week at the time of diagnosis were analyzed. RESULTS: A total of 54 pregnancies were evaluated; mean gestational week at the time of the diagnosis was 19.8 ± 4.6. Mean maternal age was 27.28 ± 6.03. Thirty-seven pregnancies were anhydramniotic, 13 fetuses had associated anomalies, five of them had multicyctic dysplastic kidney, five had bilateral renal agenesis, one had hypoplastic right heart syndrome, one had clubfoot, and one had ventricular septal defect and cleft palate. Karyotyping was normal regarding the fetuses with structural anomalies. Nineteen patients had premature preterm rupture of membranes and 39 patients had termination of pregnancy. CONCLUSION: The prognosis of early onset oligohydramnios is poor. Main determinant is gestational week at the time of the diagnosis.
Asunto(s)
Anomalías Múltiples/epidemiología , Anomalías Congénitas/epidemiología , Rotura Prematura de Membranas Fetales/terapia , Feto/anomalías , Edad Gestacional , Cardiopatías Congénitas/epidemiología , Enfermedades Renales/congénito , Riñón/anomalías , Riñón Displástico Multiquístico/epidemiología , Oligohidramnios/epidemiología , Aborto Inducido , Adulto , Antibacterianos/uso terapéutico , Corioamnionitis/prevención & control , Estudios de Cohortes , Manejo de la Enfermedad , Femenino , Humanos , Recién Nacido , Enfermedades Renales/epidemiología , Edad Materna , Oligohidramnios/etiología , Oligohidramnios/terapia , Embarazo , Primer Trimestre del Embarazo , Segundo Trimestre del Embarazo , Estudios Retrospectivos , Adulto JovenRESUMEN
We aimed to evaluate the volumetric and echogenic alterations in placentas between the intrauterine growth restriction (IUGR) and normal pregnancies using three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software. This case-control prospective study consisted of 48 singleton pregnancies complicated by IUGR and 60 healthy singleton pregnancies matched for maternal age, gestational age and parity. Placental volume (PV) and placental volumetric mean grey values (MGV) were evaluated. PV (cm(3)) was analysed using the VOCAL imaging analysis program, and 3D histogram was used to calculate the volumetric MGV (%). PV was 278.50 ± 63.68 and 370.98 ± 97.82 cm(3) in IUGR and control groups, respectively (p = 0.004). MGV of the placenta was 38.24 ± 8.41 and 38.24 ± 8.41 in IUGR and control groups, respectively (p = 0.30). receiver operator curve (ROC) curve analysis revealed that area under curve was 0.731 for PV. Correlation analysis revealed that PV was significantly associated with estimated fetal weight (r = 0.319, p = 0.003), biparietal diameter (r = 0.346, p = 0.002), head circumference (r = 0.269, p = 0.019), abdominal circumference (r = 0.344, p = 0.002) and femur length (r = 0.328, p = 0.004). PV was inversely related to the umbilical artery pulsatility index (r = - 0.244, p = 0.017). To the best of our knowledge, this is the first study evaluating volumetric MGV in IUGR placentas by comparing them with healthy pregnancies. Our study showed that PV diminishes significantly in IUGR pregnancies, whereas volumetric MGV does not alter significantly.
Asunto(s)
Retardo del Crecimiento Fetal/diagnóstico por imagen , Placenta/diagnóstico por imagen , Ultrasonografía Prenatal , Adulto , Estudios de Casos y Controles , Femenino , Retardo del Crecimiento Fetal/patología , Humanos , Imagenología Tridimensional , Placenta/patología , Embarazo , Estudios Prospectivos , Adulto JovenRESUMEN
The aim of this study is to evaluate the relationship between three-dimensional (3D) ultrasound measurements of placenta at 11-13(6) weeks' gestation and maternal serum levels of pregnancy associated plasma protein-A (PAPP-A), free beta human chorionic gonadotrophin (fßhCG), Doppler parameters in early pregnancy. This prospective study consisted of 334 singleton pregnancies at 11-13(6) weeks' gestation. Placental volume and placental volumetric mean grey values were evaluated. The placental volume (cm(3)) was analysed using the Virtual Organ Computer-aided AnaLysis (VOCAL) imaging program and 3D histogram was used to calculate the volumetric mean grey value (%). Mean maternal age was 28.35 ± 7.55. Mean gestational age was 12.29 ± 0.68 weeks. Placental volume was 77.04 ± 35.74 cm(3). Mean grey value of the placenta was 34.38 ± 8.02%. Correlation analysis revealed that placental volume was significantly correlated with the crown-rump length (r = 0.173, p = 0.002), gestational week (r = 0.116, p = 0.036), ductus venosus pulsatility index (r = -0.101, p = 0.04) and maternal weight (r = 0.099, p = 0.037). There was a significant relation between the mean grey value of the placenta and maternal age (r = 0.131, p = 0.02), nuchal translucency (r = -0.109, p = 0.048), PAPP-A (r = 0.108, p = 0.04) and fßhCG (r = 0.104, p = 0.042). Volumetry of the placenta can be carried out with a high percentage of 1st trimester pregnancies. Volumetry during the 1st trimester could be helpful because of the less advanced state of placentation. This examination is easy to perform and the measurements can be acquired correctly and quickly.
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Placenta/anatomía & histología , Placenta/diagnóstico por imagen , Embarazo/sangre , Adulto , Gonadotropina Coriónica Humana de Subunidad beta/sangre , Largo Cráneo-Cadera , Femenino , Edad Gestacional , Humanos , Imagenología Tridimensional , Edad Materna , Medida de Translucencia Nucal , Tamaño de los Órganos , Primer Trimestre del Embarazo/sangre , Proteína Plasmática A Asociada al Embarazo/metabolismo , Estudios Prospectivos , Turquía , Ultrasonografía Doppler , Adulto JovenRESUMEN
The aim of the present study was to evaluate the effect of sunitinib on endometriotic implants and adhesions in a rat endometriosis model. An experimental endometriosis model was created in 21 rats. These rats were randomly divided into three groups: Group 1 (control group, 7 rats) was given no medication; Group 2 (sunitinib group, 7 rats) was given 3 mg/kg per day of oral sunitinib; and Group 3 (danazol group, 7 rats) was given 7.2 mg/kg per day of oral danazol. The volume of endometriotic implants was calculated. The extent and severity of adhesions were evaluated. The groups were compared by the Student's t-test, analysis of variance (ANOVA) and the Mann-Whitney U test. There was no statistically significant difference in the mean volume of endometriotic implants before medication between three groups. The volume of implants and extent, severity, total score of adhesions were significantly decreased after medication in Group 2 and Group 3. We noted that the volume of the endometriotic implants and adhesion formation were decreased both after sunitinib and danazol treatment. As a result, sunitinib seems to be effective for endometriotic peritoneal lesions. The effects of sunitinib in rat models give hope for improving the treatment of human endometriosis and prevention of pain symptoms.
Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Endometriosis/tratamiento farmacológico , Indoles/uso terapéutico , Enfermedades Peritoneales/tratamiento farmacológico , Pirroles/uso terapéutico , Animales , Danazol/uso terapéutico , Modelos Animales de Enfermedad , Endometriosis/complicaciones , Antagonistas de Estrógenos/uso terapéutico , Femenino , Enfermedades Peritoneales/etiología , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Sunitinib , Adherencias Tisulares/tratamiento farmacológico , Adherencias Tisulares/etiologíaRESUMEN
PURPOSE OF INVESTIGATION: The authors aimed to determine the prevalence of female sexual dysfunction (FSD) among Turkish dyspareunic women and to establish the associated factors with FSD. Furthermore, they aimed to investigate if dyspareunia and possible associated sexual complaints were related to impaired quality of life (QoL). MATERIALS AND METHODS: The study included 154 women admitted to the present gynecology department at a tertiary center in the west region of Turkey, 67 of which suffered from dyspareunia. The remaining 87 sexually healthy women were included in the control group. FSD was assessed with 19-item validated female sexual function index (FSFI). QoL was assessed using short form 36 (SF-36). The chi-squared test and t-test were used for analysing the group differences. Pearson's correlation test was used to determine the effect of the variables of FSFI on the SF-36. Multivariance analysis and logistic regression was used to determine independent risk factors for FSD and to estimate odds ratio (OR) with 95% confidence interval (CI). RESULTS: The incidence of FSD in dyspareunic group and control group was 86.57% and 36.8%, respectively (p < 0.001). Dyspareunic women had lower scores with regards to sexual desire, arousal, lubrication, orgasm, satisfaction, and pain domains at significant level (p < 0.001). Education level, time period after the last delivery, duration of marriage, parity, and dyspareunia were significantly related to FSD. However, dyspareunia was an independent risk factor for FSD (OR 11.49; 95% CI 4.95-26.67). Regarding the impact on the QoL, dyspareunic women had lower scores with regards to the physical role, social function, bodily pain, and vitality domains. CONCLUSION: The present results show that dyspareunia has a major impact on women's sexual function and QoL. Clinicians have an important role for encouraging women to report their sexual complaints. Identifying dyspareunia and treating FSD may positively affect women's sexual function and overall QoL.