Human reproduction
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Relationship between stage, site and morphological characteristics of pelvic endometriosis and pain.
The relationship between frequency and severity of pain symptoms and site, stage and morphological characteristics of endometriotic lesions was analysed in a multicentre cross-sectional observational study. ⋯ The results of this study find no clear-cut association between stage, site or morphological characteristics of pelvic endometriosis and pain.
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Congenital adrenal hyperplasia (CAH) is a well-recognized, but uncommon, cause of azoospermia and infertility in men. Commonly this is due to undertreatment of excessive adrenal androgen secretion which suppresses gonadotrophin stimulation of the testes. ⋯ Investigations concluded that there was adequate adrenal suppression with glucocorticoids and that azoospermia was due to obstruction by adrenal rest tissue, strategically situated at the hilum of the testes. Spermatozoa were able to be retrieved by testicular aspiration from the man and these were used to successfully establish a pregnancy using intracytoplasmic sperm injection of his wife's oocytes.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A multicentre randomized controlled trial of oral misoprostol and i.m. syntometrine in the management of the third stage of labour.
Postpartum haemorrhage accounts for nearly 28% of maternal mortality in developing countries. Syntometrine is an effective and commonly used oxytocic in preventing postpartum haemorrhage, but it requires a controlled storage environment and i.m. administration. Misoprostol is an orally active uterotonic agent. ⋯ The need for additional oxytocic injection was significantly higher in the misoprostol group [relative risk (RR) 1.62, 95% confidence interval (CI) 1.34-1.96], but that of manual removal of placenta was reduced (RR 0.29, 95% CI 0.09-0.87). Shivering and transient pyrexia were more common in the misoprostol group. Oral misoprostol might be used in the management of the third stage, especially in situations where the use of syntometrine is contraindicated and facilities for storage and parenteral administration of oxytocics are limited.
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Obstetric and neonatal outcomes of women who had a history of recurrent miscarriage were compared with a control population from 1 January 1992 to 30 June 1998. Amongst a total of 162 pregnancies which progressed beyond 24 weeks gestation in women with a history of recurrent miscarriage, there were four perinatal deaths and 16 babies were admitted to the special care baby unit. ⋯ There was no significant difference in the incidence of hypertension or diabetes between the two groups. Patients with recurrent miscarriage represent a population at high risk of obstetric problems and close surveillance in the antenatal period is therefore required.
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Editorial Comparative Study
Geographical distribution of publications in Human Reproduction and Fertility and Sterility in the 1990s.
Curious about the geographical distribution of publications in reproductive medicine, we compared the numbers of publications in Human Reproduction (HR) and Fertility and Sterility (F&S). The annual number of publications from the individual countries was obtained by searching the Medline database using the internet provider PubMed. The data were analysed and normalized to population size, gross domestic product (GDP) and total number of Medline publications. ⋯ In conclusion, the geographical distribution of publications in HR and F&S follows the pattern of the distribution of publications in general biomedical research. Most publications come from affluent countries. Although the USA and the UK appear to be the most productive countries in absolute numbers, smaller affluent countries like Israel and Belgium are more productive when the numbers are normalized to population or GDP.