J Reprod Med
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Randomized Controlled Trial
Efficacy of letrozole in ovulation induction compared to that of clomiphene citrate in patients with polycystic ovarian syndrome.
To compare the efficacy of letrozole with clomiphene citrate for ovulation induction in patients with polycystic ovarian syndrome (PCOS). ⋯ Letrozole might be an acceptable alternative to clomiphene citrate to induce ovulation and pregnancy in PCOS patients.
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Randomized Controlled Trial
Use of intravaginal electrical stimulation for the treatment of chronic pelvic pain: a randomized, double-blind, crossover clinical trial.
To assess the efficacy of intravaginal electrical stimulation (IVES) or placebo in women with chronic pelvic pain (CPP) with no apparent cause. ⋯ Intravaginal electrical stimulation was more effective than a placebo in alleviating pain in women with CPP.
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Case Reports
Amniotic fluid embolism treated with emergency extracorporeal membrane oxygenation: a case report.
Amniotic fluid embolism (AFE) is a rare disorder classically characterized by the abrupt onset of hypotension, hypoxia and consumptive coagulopathy during delivery or in the immediate postpartum period. It is postulated that amniotic fluid,fetal cells, hair or other debris enters the maternal circulation, causing cardiopulmonary collapse. The precise pathophysiologic mechanism remains elusive, treatment is supportive, and AFE carries a mortality of up to 80%. ⋯ Though there is no definitive treatment for AFE, ECMO provided oxygenation and allowed the patient to recover. ECMO may be useful in the treatment of severe cases of AFE.
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Torsion of adnexa usually manifests with severe abdominal pain and is treated as an acute surgical emergency. Asymptomatic torsion, necrosis and amputation of an ovary, and sometimes with other adnexal structures as well, are extremely rare. ⋯ Physicians should bear in mind the possibility of an autoamputated ovarian cyst even if the preoperative radiograph shows no calcification.
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Case Reports
Ovarian ectopic pregnancy 6 years after supracervical cesarean hysterectomy: a case report.
Pregnancy after hysterectomy is very rare, with fewer than 40 cases reported in the English-language literature. The majority of cases are diagnosed in the early posthysterectomy, postoperative period, indicating that the pregnancy was present at the time of hysterectomy. Cases diagnosed remotely from the time of hysterectomy result from a fistulous tract allowing sperm access to the peritoneal cavity. ⋯ A woman with intact ovaries presenting with abdominal pain, despite a prior hysterectomy, should be considered at risk for ectopic pregnancy. The presence of a cervix may increase that risk.