RESUMEN
AIM: The present study aims to compare the effectiveness of placebo, low dose and very low dose oral contraceptives (OC) in the treatment of clomiphene citrate (CC)-related ovarian cysts. METHODS: A prospective randomized placebo controlled study was undertaken at the Infertility Department of Dr. Zekai Tahir Burak Women's Health Education and Research Hospital. A total of 3250 primary infertile patients were administered CC for ovulation induction because of ovulatory dysfunction and/or unexplained infertility. One hundred and eighty-six women who were diagnosed with CC-related ovarian cysts greater than 20 mm on the third day of the following menstrual cycle, were eligible for the study. Group 1 (n = 62) was treated with very low dose OC (100 microg levonorgestrel + 20 microg ethinyl estradiol [EE]), group 2 (n = 62) with low dose OC (150 microg desogestrel + 30 microg EE) and group 3 (n = 62) with a placebo. The first control was 4 weeks later. Women with persistent cysts (n = 57) were called in 4 weeks later to continue the same treatment. RESULTS: Demographic data were similar among the groups. At the first month, the regression rates of ovarian cysts were 64.5, 61.3 and 66.1% in groups 1, 2 and 3, respectively (P = 0.849). Among the 57 women (20, 19 and 18 from groups 1, 2 and 3, respectively) with persistent cysts, the regression rates were 65.0, 63.2 and 55.6%, respectively at the second month (P = 0.821). Persistence of ovarian cysts was significantly higher in women with a longer duration of CC treatment than in women with a shorter duration (P < 0.001). CONCLUSION: Any treatment might be appropriate for patients with a CC-related ovarian cyst. However, there is no evidence to administer OC for treating CC-related ovarian cysts. Expectant management may also achieve similar success rates.
Asunto(s)
Clomifeno/efectos adversos , Etinilestradiol/administración & dosificación , Infertilidad Femenina/tratamiento farmacológico , Levonorgestrel/administración & dosificación , Quistes Ováricos/inducido químicamente , Quistes Ováricos/tratamiento farmacológico , Adulto , Análisis de Varianza , Índice de Masa Corporal , Distribución de Chi-Cuadrado , Anticonceptivos Sintéticos Orales/administración & dosificación , Quimioterapia Combinada , Estrógenos/administración & dosificación , Femenino , Fármacos para la Fertilidad Femenina/efectos adversos , Humanos , Estudios Prospectivos , Resultado del TratamientoAsunto(s)
Eosinofilia/patología , Plasminógeno/deficiencia , Cervicitis Uterina/patología , Vaginitis/patología , Biopsia con Aguja , Dismenorrea/diagnóstico , Dismenorrea/etiología , Eosinofilia/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Enfermedades Raras , Medición de Riesgo , Cervicitis Uterina/complicaciones , Cervicitis Uterina/diagnóstico , Vaginitis/complicaciones , Vaginitis/diagnóstico , Adulto JovenRESUMEN
OBJECTIVE: This study evaluated the predictive factors and short-term fetal outcomes of breech presentation by comparing breech and cephalic pregnancies of >or=36 weeks gestation. MATERIALS AND METHODS: Two hundred and one breech and 149 cephalic pregnancies of >or=36 weeks gestation, with no other maternal or fetal problems, were compared with regard to placental localization, fetal heart rate variability, smoking, body mass index, maternal weight gain, placental weight, birth weight, sex, Apgar scores, and umbilical cord length. RESULTS: Maternal weight gain, body mass index at term, smoking and hemoglobin values were significantly higher in breech presentation than in cephalic pregnancies. The placenta was located in the cornu-fundal region in 63.2% of breech presentations and 26.8% of cephalic presentations (p<0.001). Placental weights were 657 g and 597 g, respectively (p<0.001). Umbilical cord length was shorter in breech than cephalic pregnancies (p<0.001). Although breech pregnancies had significantly reduced fetal heart rate variability (p<0.001), Apgar scores were much higher in breech fetuses than in cephalic fetuses. Ninety-five percent of breech pregnancies underwent cesarean sections. CONCLUSION: Cornu-fundal localization of the placenta, smoking, greater maternal weight gain, higher body mass index at term, greater placental weight, shorter umbilical cord, and lower estimated fetal weight may be predictive of persistent breech presentation. Reduced fetal heart rate variability did not have an adverse effect on Apgar scores after cesarean delivery in breech fetuses with no other problems at term.