International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · May 2001
Comparative StudyInvestigation of the uterine cavity and fallopian tubes using three-dimensional saline sonohysterosalpingography.
To compare three-dimensional saline sonohysterosalpingography (SHSG) to X-ray hysterosalpingography (HSG) for the evaluation of the uterine cavity and fallopian tubes. ⋯ Transvaginal three-dimensional saline SHSG provides good visualization of the uterine cavity and myometrial walls in three orthogonal planes. However, it does not diagnose tubal occlusion or depict architecture of the fallopian tube as accurately as X-ray HSG. Although we were able to visualize the distal fallopian tube and fimbria with real-time imaging, we were not able to satisfactorily image the proximal tube with three-dimensional power Doppler. This technique may be reserved as an initial screening test to evaluate the uterine cavity and test patency. Patients at high risk for tubal disease by history or with suspected tubal occlusion on three-dimensional saline SHSG should be evaluated by either X-ray HSG or laparoscopy with chromopertubation. Further improvements of three-dimensional technology and contrast materials will, it is hoped, make this method comparable to X-ray HSG.
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Int J Gynaecol Obstet · Apr 2001
Randomized Controlled Trial Clinical TrialMisoprostol for prevention of postpartum hemorrhage.
To compare the effectiveness of 400 microg rectal misoprostol in 5 cm(3) of saline with oxytocin 10 IU, i.m., in reducing bleeding during the third stage of labor. ⋯ Misoprostol administered as a micro-enema, 400 microg in 5 ml of saline during the third stage of labor, appears to be as effective as oxytocin 10 IU, i.m., but misoprostol produced more side effects than oxytocin.
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To compare maternal and neonatal outcomes in elective cesarean vs. attempted vaginal delivery for breech presentation at or near term. ⋯ Cesarean delivery of selected near-term infants presenting as breech is associated with increased maternal morbidity without corresponding improvement in neonatal outcomes.
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Int J Gynaecol Obstet · Jan 2001
Comparative StudyPregnancy complicated by pre-eclampsia-eclampsia with HELLP syndrome.
To determine the incidence of, and assess the relationship between liver enzymes and platelet counts with the severity of HELLP (hemolysis elevated liver enzymes and low platelet count) syndrome, and describe incidences of serious maternal complications. ⋯ This study supports the theory that HELLP syndrome is associated with increased maternal morbidity and mortality. Our data suggest that certain subgroups of patients with class 1 HELLP syndrome ('classic or true HELLP') are at increased risk for serious maternal complications, including those with: platelet counts below 50000/microl; lactic dehydrogenase> or = 2000 IU/l; aspartate aminotranferase> or = 500 IU/l; alanine aminotransferase> or = 300 IU/l; and hematuria.