Minerva ginecologica
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Neuromodulation utilizes electrical stimulation to alter the function of an organ. Recent advances in technology and improved knowledge of micturition physiology have coincided with the growth of neuromodulation for the treatment of urinary urgency/frequency, urge incontinence and non-obstructive urinary retention. ⋯ This review will highlight the current indications, patients selection, implantation options/techniques, outcomes and complications of sacral neuromodulation. In addition, other methods of neuromodulation will be discussed.
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The aim of this article is to present a review on the influence of endometriosis on assisted reproductive techniques (ART), as well as on the influence of ART on endometriosis. Based on recent literature, this article will try to answer the following questions: 1) Does endometriosis change the success rate of ovulation induction (OI), intrauterine insemination (IUI) and in vitro fertilisation (IVF) and does previous chirurgical treatment of endometriosis change the success rate of OI, IUI and IVF? 2) Do ART alter the course of the disease? In order to answer these questions, we based ourselves on the following recent guidelines and reviews by reknown experts on endometriosis: the ESHRE Guideline for the Diagnosis and Treatment of Endometriosis, The Practice Committee of the American Society for Reproductive Medicine: Endometriosis and Fertility; a recent review paper on the relationship between endometriosis and subfertility and a recent meta-analysis on the relationship between endometriosis and ART. This review was then completed using more recent papers, published on PubMed as well as background articles, important references and own research papers presented at international meetings. ⋯ The presence of endometriosis has a negative effect on the pregnancy rate after ART. It is unclear if surgical treatment prior to ART may increase the pregnancy rate after ART. It is also unclear if ART is a risk factor for recurrence/progression of endometriosis.
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Postpartum hemorrhage, frequently due to uterine atony, is an important cause of maternal death and morbidity. The knowledge of causes, of antenatal and intrapartum risk factors and of physiopathological changes in hemodynamics and coagulation during pregnancy are essential for the management of the condition. ⋯ The developments in the treatment of postpartum hemorrhage may reduce hysterectomy that is to be considered the last resort to resolve the hemorrhage in some cases. In the modern management of postpartum hemorrhage protocols and guidelines should be available in every delivery room.
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Minerva ginecologica · Aug 2003
ReviewPeritoneal fluid environment in endometriosis. Clinicopathological implications.
Endometriosis is a puzzling disorder with obscure pathogenesis. The objective of this review was to evaluate the complex role of peritoneal fluid in the etiopathogenesis of endometriosis. Several studies suggest that peritoneal fluid is a key inflammatory environment associated with endometriosis. ⋯ Inflammatory mediators may be involved in the endometriosis associated-infertility and possibly pain. Furthermore, these mediators may represent a non surgical method for diagnosing endometriosis. Better understanding of the mechanism of cytokines, growth factor and reactive oxygen species production and detoxification and further investigation of their effects on the peritoneal fluid environment are essential to obtain new insight into this disease and eventually develop novel diagnostic and therapeutic remedies.
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Hypertension is the most common medical disorder during pregnancy. Chronic hypertension is a serious medical complication in pregnancy with increased maternal and perinatal morbidity and mortality. ⋯ Fetal complications include prematurity, low birth weight, and perinatal death. Careful antepartum, intrapartum and postpartum management of women with high-risk chronic hypertension in pregnancies may reduce morbidity and mortality.