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D Bider

Publications and source records attributed to D Bider.

At least 73 records · Page 4Linked to original sources
PubMed1992

Effect of intraumbilical prostaglandin F2 alpha injection on the third stage of labor.

The effect of an intraumbilical prostaglandin (PG) F2 alpha injection on the third stage of normal labor was studied in 54 normal, laboring women at term. Either 1 mg of PGF2 alpha diluted to 20 mL in normal saline (27 women) or 20 mL of normal saline alone (27 women) was injected into the umbilical vein immediately after delivery using a randomized, double-blind protocol. The mean (+/- SD) duration of the third stage was 7.31 +/- 6.37 minutes in the PGF2 alpha patients and 8.94 +/- 7.10 in the normal saline patients. Intraumbilical PGF2 alpha did not influence the third stage of normal labor.

Adult↗
PubMed1991

Combined gonadotropin releasing hormone agonist/human menopausal gonadotropin therapy (GnRH-a/hMG) in normal, high, and poor responders to hMG.

Patients who failed to conceive after gonadotropin stimulation in in vitro fertilization treatment were classified into normal, high, or poor responders. They were routinely offered another cycle with a combination of a gonadotropin releasing hormone agonist and gonadotropin therapy (in order to evaluate whether this combined therapy could improve their response). The gonadotropin-induced cycle was compared with the combined therapy cycle. With the combination treatment, in the normal responders the phase of ovarian stimulation was significantly (P less than 0.001) prolonged, and the number of follicles and oocytes collected (5.7 +/- 0.7 vs 3.1 +/- 0.4) was increased, without any change in serum estradiol level compared to the control cycle. In high responders the number of oocytes was not modified by the combined treatment compared with the control cycle. However, serum estradiol level was significantly (P less than 0.005) decreased. The combined therapy did not modify any parameter of response in poor responders. We conclude that the response to combined agonist/gonadotropin therapy is dependent on the patient's own basal response. No improvement in response was expected in poor responders.

Delayed-Action Preparations↗
PubMed1991

Hysteroscopy in a program of in vitro fertilization.

Two hundred twenty-four women underwent hysteroscopic evaluation without anesthesia after at least two failed attempts of in vitro fertilization and embryo transfer. One hundred fifty-three (68%) women were diagnosed as having mechanical infertility, and abnormal hysteroscopic findings were observed in 32 (21%). Forty-one women were diagnosed as having unexplained infertility (18%) and six (15%) had abnormal findings with hysteroscopy. Of the 30 couples who entered the in vitro fertilization regimen program because of male infertility, 4 (13%) had abnormal findings. The overall rate of abnormal findings was 19%; cervical canal and intrauterine abnormalities were found in 10 and 32 patients, respectively. Ten patients were treated during hysteroscopic evaluation procedure, and four patients subsequently underwent operative hysteroscopy under general anesthesia. We suggest that diagnostic hysteroscopy should be a routine procedure before in vitro fertilization and embryo transfer therapy.

Adult↗
PubMed1991

Ovarian hyporesponsiveness in combined gonadotropin-releasing hormone agonist and menotropin therapy is associated with low serum follicle-stimulating hormone levels.

The study was designed to evaluate if ovarian hyporesponsiveness, which is associated with combined gonadotropin-releasing hormone agonist (GnRH-a) and human menopausal gonadotropin (hMG) therapy is because of suboptimal serum follicle-stimulating hormone (FSH) levels. Two groups of 12 patients each were suppressed with GnRH-a and stimulation with a fixed dose of hMG. The control group (n = 10) received equal doses of hMG only. The follicular phase and the number of hMG ampules was significantly higher in the study group. Basal FSH levels and FSH levels during hMG treatment were significantly lower in patients treated with GnRH-a. Peak estradiol levels and the outcome of in vitro fertilization treatment were similar in the three groups. We suggest that the delay in ovarian response in patients treated with a combination of GnRH-a and hMG is because of lack of endogenous contribution of FSH, resulting in low circulating levels of FSH. An increase of serum FSH levels by administration of higher doses of hMG can reverse this effect.

Adult↗
PubMed1991

Cytokine involvement in oocytes and early embryos.

OBJECTIVE: The early events of reproduction involve a carefully modulated complex system of oocyte maturation, fertilization, and proliferation. The aim of the study was to measure the presence of cytokines, namely interleukin 1 (IL-1), interleukin 6 (IL-6), colony-stimulating factor 1 (CSF-1), and tumor necrosis factor (TNF) in the conditioned medium (CM) of the oocytes, granulosa cells, cumulus cells, one to eight-cell embryos and sperm. DESIGN: The material was obtained from men and women undergoing in vitro fertilization therapy. MAIN OUTCOME MEASURES: We hypothesized that cytokines might affect embryonic growth and differentiation as they show a pleotropic effect on immune cells. RESULTS: All these cytokines are present in significant quantities in the CM and were shown to be expressed in a sequential manner; thus, some are present in the oocyte and its vestment, the corona-cumulus complex (IL-1, IL-6, and CSF-1), whereas TNF appears only at the stage of six to eight-cell embryos. Inflammatory cytokines could not be detected in sperm samples. CONCLUSIONS: It is possible that these cytokines have a role in the regulation of embryonic development, maternal immunological recognition of pregnancy, and maintenance of proper hormonal environment.

Cytokines↗
PubMed1991

Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin.

A patient who suffered from polycystic ovarian disease and anovulation, was treated with pure follicle stimulating hormone for induction of ovulation. The treatment was stopped and human chorionic gonadotrophin was not administered because of high serum oestradiol levels and multiple follicular development. Ovulation occurred 11 days after pure follicle stimulating hormone was discontinued, the patient developed third-degree ovarian hyperstimulation syndrome and conceived with a quintuplet pregnancy.

Adult↗
PubMed1991

Hormonal profiles and follicular growth in cycles with imminent ovarian hyperstimulation.

Ovarian hyperstimulation syndrome is a common and serious complication of human menopausal gonadotrophin/human chorionic gonadotrophin treatment. We evaluated the changes in the pituitary and ovarian hormone profiles and ultrasonographic follicular regression in 12 patients in whom human menopausal gonadotrophin was discontinued due to 'imminent' ovarian hyperstimulation. Following discontinuation, three distinct periods were observed: (i) days 1-2, the levels of oestradiol, testosterone and prolactin, and the total number of follicles continued to rise; (ii) days 3-6, the levels of oestradiol, testosterone and prolactin declined sharply and the total number of follicles was reduced significantly, while the large and medium sized follicles continued to increase. Levels of follicle-stimulating hormone and luteinizing hormone gradually declined to reach their lowest levels by days 5-6 and then increased. (iii) Thereafter the number of follicles and steroid output declined to early follicular phase levels. We conclude that discontinuation of human menopausal gonadotrophin and withholding human chorionic gonadotrophin in cycles with laboratory signs of 'imminent' ovarian hyperstimulation syndrome, allows regression of the ovarian ultrasonographic finding and prevents the development of clinical symptoms. However, if rescue of the cycle is attempted, human chorionic gonadotrophin should be given during the first 4 days after discontinuation of stimulation.

Adult↗
PubMed1991

Meteorological factors in hypertensive disorders, vaginal bleeding and premature rupture of membranes during pregnancy.

In order to determine whether there is a correlation between meteorological factors and the occurrence of hypertensive disorders, vaginal bleeding during pregnancy and premature rupture of the fetal membranes, we stratified all the patients hospitalized with such complications between the years 1984 and 1988 by the months of occurrence, weather, humidity and heat. During this period, there were 276 women hospitalized with exacerbation of hypertension and toxemia, 349 because of vaginal bleeding during pregnancy and 35 women following premature rupture of the fetal membrane between 30 and 33 weeks of gestation. The occurrence of pre-eclampsia and exacerbation of pregnancy-induced hypertension was significantly increased in the winter months (p less than 0.001).

Female↗
PubMed1991

Oxytocin or saline injected intra-umbilically did not influence the third stage of labor.

The injection of varying volumes of normal saline solution, alone or with oxytocin, into the umbilical vein immediately after delivery was studied in 125 normal women delivered at term. Thirty seconds after cord clamping, either 20 ml (group 1, n = 25 women), 30 ml (group 2, n = 25) or 40 ml (group 3, n = 25) of normal saline solution alone, or oxytocin 10 units in 20 ml saline solution (group 4, n = 25) or oxytocin 10 units in 40 ml saline solution (group 5, n = 25) were injected into the umbilical vein 1 cm from the introitus just proximal to the umbilical clamp. The mean (+/- SD) duration of placental expulsion was similar in the five study groups. We conclude that neither the volume of the solution nor the oxytocin injected intra-umbilically has any effect on the duration of the third stage of normal labor.

Adult↗
PubMed1991

Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women.

A series of 101 patients with adnexal torsion during a 12 year period are reviewed. Twenty patients were pregnant at the time of diagnosis and underwent surgical treatment. Preoperatively, the correct diagnosis was not established in four pregnant patients and in 30 nonpregnant patients. An operation was usually delayed for more than 24 hours. Unwinding of the twisted adnexa, regardless of its appearance, was the main surgical procedure in both groups. The outcome of the pregnancies was favorable. The main histopathologic findings in both groups were cysts of the follicular or corpora lutea.

Adnexal Diseases↗
PubMed1991

The role of cervical cerclage in the management of uterine anomalies.

The effect of cervical cerclage on the survival rate of the fetus was studied in 86 pregnancies of women with congenital uterine anomalies and a random group of 106 pregnancies in women with normal shaped uteri. The uterine morphologic factors were determined in all by hysterosalpingography, and when necessary, hysteroscopy and laparoscopy were combined. The incidence of hysterosalpingography-proved cervical incompetence (23 per cent) was similar in both groups. Sixty-seven and 29 pregnancies were managed with cervical cerclage in each group, respectively. The fetal outcome was stratified by cervical incompetence and obstetric history. The percentage of viable newborns was significantly higher in women with malformed uteri who underwent cerclage (88 per cent) compared with those without cerclage (47 per cent). No statistically significant beneficial effect of cerclage was found for normal uteri, even when only those with a history of recurrent fetal loss were considered.

Female↗
PubMed1991

Uterine anomalies. A retrospective, matched-control study.

The obstetric risk associated with congenital uterine malformations was studied in a group of 67 women who had undergone hysterosalpingography (HSG) during an eight-year period. HSG was performed to investigate primary (21% of the cases) and secondary (19%) infertility (group 1) or recurrent early fetal loss (60%) (group 2). The study group was compared with a random control group of 130 patients with HSG-proven normal uteri, matched for the presenting symptom. Prematurity and intrauterine fetal death were found to be significantly more common (P less than .05) for women in group 1 with uterine anomalies. The mean birth weight for preterm infants (less than 37 weeks) was significantly lower (P less than .01) for women with malformed uteri. The incidence of antepartum bleeding during pregnancy (P less than .01), breech presentation and cesarean section (P less than .001) was significantly higher for the study group. Premature rupture of the membranes was diagnosed more frequently (P less than .05) only in group 1. Patients with congenital uterine anomalies are a high-risk obstetric group. Primary infertility may be a more common presenting complaint in women with uterine anomalies than previously recognized.

Abortion, Habitual↗
PubMed1990

Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy.

A series of 201 cycles of ovarian hyperstimulation syndrome (OHSS) in 154 women were reviewed. Pregnancy occurred in 75 of 201 cycles. Twelve pregnant women (16%) presented with torsion of hyperstimulated ovary, but only 3 out of 126 patients (2.3%) who did not conceive had torsion. Because diagnosis of adnexal torsion is usually uncertain and surgical intervention is likely to be delayed, these infertile women risk losing their ovaries. The clinical picture of torsion of adnexa in patients with OHSS is presented here. The combination of ovarian enlargement, abdominal pain, nausea, progressive leukocytosis, and anemias might indicate torsion of adnexa. Although during operation the adnexa appears dark, hemorrhagic and ischemic, we suggest that it can be saved by simply unwinding it. In 11 such cases intraoperative unwinding of the adnexa was performed, and in 8 patients it was the only operative procedure. No postoperative complications were noted and in all the cases the ovaries were proven functional by ultrasonography. We concluded that torsion of hyperstimulated adnexa in patients who conceived after gonadotropin therapy, is a special entity that requires more attention to achieve early diagnosis. Nevertheless even with delayed diagnosis, the ovary can still be saved.

Adnexal Diseases↗
PubMed1990

Laparoscopic unwinding of twisted ischemic hemorrhagic adnexum after in vitro fertilization.

We present a case where, for the first time, unwinding of ischemic hemorrhagic adnexum was performed successfully through the laparoscope without the need to operate. Aspiration of ovarian fluid before detorsion facilitates the procedure; follow-up showed spontaneous follicular growth. We conclude that laparoscopic detorsion of ischemic adnexum is feasible. Apparently, oocytes are not damaged by the torsion and the ovary resumes normal function. This procedure should be considered in women during the reproductive age and in every case where malignancy can be ruled out.

Adnexal Diseases↗
PubMed1990

Follicular and luteal cysts after treatment with gonadotropin-releasing hormone analog for in vitro fertilization.

Ovarian cysts are a common complication of GnRH-a administration. We followed 98 patients who were suppressed with GnRH-a before ovarian stimulation with hMG for IVF treatment. Approximately 20% of the patients receiving GnRH-a during the follicular or luteal phase had developed ovarian cysts. However, the number of cysts per patient was significantly higher in the follicular phase compared with luteal phase. Systematic aspiration of those cysts under local anesthesia permitted the start of ovarian stimulation with hMG as scheduled on day 16 after GnRH-a administration. Follicular fluid content of the cysts revealed similar levels of steroids to those in normal follicles. These cysts contained few cells and no egg. In vitro fertilization treatment was more successful in patients whose cysts were aspirated during the luteal phase than in those with cysts during the follicular phase. We concluded that luteal phase cysts are more benign than follicular phase cysts, and it is possible that they represent an enlargement of pre-existing corpora lutea.

Adult↗