PubMed Health⌕ Search

Biomedical subjects

E C Wood

Publications and source records attributed to E C Wood.

At least 19 recordsLinked to original sources
PubMed1992

Laparoscopically assisted hysterectomy.

OBJECTIVE: To determine the feasibility and effectiveness of laparoscopically assisted hysterectomy. DESIGN: A prospective study of the planned surgical procedure was carried out by two teams, each with two gynaecologists, who were experienced in operative laparoscopy. SETTING: The operations were carried out in a private hospital, where advanced operative laparoscopy equipment was available. PATIENTS: Seventeen patients were selected for the procedure, all of whom required hysterectomy for symptoms of pain or menorrhagia in association with uterine or other pelvic disease. Patients with carcinoma or uterine enlargement beyond 12 cm were excluded. PROCEDURE: Laparoscopically assisted hysterectomy was carried out by means of a video monitor, uterine manipulation by vaginal instrumentation, three or four abdominal punctures of less than 1 cm, and bipolar diathermy to secure vascular pedicles. The uterus was removed from the vagina by cutting vaginal skin and the cardinal ligaments. RESULTS: The operating time was 90-220 min, the blood loss was 30-200 mL, and the hospital stay lasted two to five days and convalescence two to four weeks. No serious complications occurred. CONCLUSIONS: Laparoscopically assisted hysterectomy may be valuable when adnexal or uterine abnormalities are present and vaginal hysterectomy is either contraindicated or more difficult. The procedure requires special equipment and may only be carried out by experienced gynaecological operative laparoscopists. Its acceptance will depend upon reducing the operating time to less than 90 min. It has the advantage of reducing the duration of hospital stay and the duration of convalescence when compared with abdominal hysterectomy.

Adult↗
PubMed1990

A comparison of vaginal ultrasonic-guided and laparoscopic retrieval of oocytes for in vitro fertilization.

A retrospective analysis was undertaken to compare the less invasive technique of vaginal ultrasonic-guided oocyte retrieval with the standard laparoscopic technique. We have shown that the outcome of the transvaginal technique with respect to oocytes harvested, fertilization rate, and pregnancy rate is comparable with the laparoscopy technique. We have also shown that 9 clinicians with little previous expertise in ultrasound have been able to incorporate this technique into a busy and successful in vitro fertilization unit.

Female↗
PubMed1990

Referral issues in psychotherapy and psychoanalysis.

The authors consider the complex decisions involved in the initial consultation of a person looking for treatment when this person must be referred to a professional colleague. They explore the way decisions are made in the referral processes and the complex practical and transference-countertransference issues that arise at the outset and whenever second opinions are sought during an ongoing psychotherapy. They present four clinical examples in varying detail to emphasize how readily misunderstandings can develop when even experienced consultants are not sufficiently alert to the complex conscious and unconscious motives and messages being expressed in the exchanges. They make recommendations on how to conceptualize and respond to them.

Countertransference↗
PubMed1989

A prospective study of prognostic factors in in vitro fertilization and embryo transfer.

Multiple factors influence the outcome of in vitro fertilization and embryo transfer (IVF-ET). This prospective study was designed to assess their relative importance, in order to improve prognostic ability and treatment success. Prior to IVF-ET, couples were divided into "good" (GP) and "poor" (PP) prognosis groups according to female age, semen quality, previous response to stimulation, and embryo quality. The data obtained from 716 consecutive treatment cycles then were evaluated using univariate statistics and logistic regression, a technique designed to assess the relative contribution of significant factors. The pregnancy rate per GP cycle was 14.7%, compared with 5.4% per PP cycle (chi 1(2) = 12.7, P less than 0.001). The most important prognostic factors were female age, the pregnancy rate showing a linear decline after the age of 25, and previous failed fertilization due to abnormal sperm. The rate of pregnancy also declined after 14 or more follicles were aspirated and/or nine oocytes were retrieved. A formula for the probability of pregnancy, derived from the logistic regression, provides patients with a more accurate prognosis before treatment.

Adult↗
PubMed1988

Antenatal serum levels of relaxin in patients having preterm labour.

This study is the first report of antenatal levels of relaxin measured by homologous radioimmunoassay in peripheral serum from patients who subsequently had a preterm delivery. Serial blood samples were collected antenatally from a group of subjects known to be at increased risk of preterm labour because of a past history of shortened pregnancy. Serum relaxin was measured using an homologous radioimmunoassay based on a synthetic bioactive analogue of the native hormone. In women whose pregnancies ended preterm most measurements were within the range of values previously established in normal antenatal patients although some measurements early in pregnancy were above the normal range. These findings suggest that low serum levels of relaxin are not causatively related to the onset of labour before term.

Female↗
PubMed1987

Predictive value of plasma human chorionic gonadotrophin beta subunit in diagnosing ectopic pregnancy after in vitro fertilisation and embryo transfer.

A study was conducted aimed at establishing a range of plasma concentrations of the beta subunit of human chorionic gonadotrophin that might predict ectopic pregnancy after in vitro fertilisation and embryo transfer. From May 1984 to February 1986, 161 consecutive pregnancies at the Monash University in vitro fertilisation unit were analysed by determining plasma beta human chorionic gonadotrophin concentrations between two and 10 weeks after oocyte collection. Eighty eight ongoing singleton pregnancies, 25 multiple pregnancies, 27 first trimester spontaneous abortions, 12 anembryonic pregnancies, and nine ectopic pregnancies resulted from these conception cycles. When compared with values for ongoing singleton pregnancies two weeks after oocyte collection plasma beta human chorionic gonadotrophin concentrations in ectopic pregnancies were significantly lower (p less than 0.05; Wilcoxon rank sum test). Two weeks after oocyte collection all plasma beta human chorionic gonadotrophin concentrations in the set of ectopic pregnancies were below 30.6 IU/l, which corresponded to the lower quartile (25th percentile) of beta human chorionic gonadotrophin concentrations in ongoing singleton pregnancies. The beta human chorionic gonadotrophin concentration corresponding to the lower quartile of ongoing singleton pregnancies at each week of gestation was used to derive the predictive value of various statistics in detecting ectopic pregnancy in patients after in vitro fertilisation. The sensitivity, specificity, predictive value of a positive result, predictive value of a negative result, and efficiency of a single plasma beta human chorionic gonadotrophin concentration in predicting ectopic pregnancy were 100%, 68.1%, 16.7%, 100%, and 70%, respectively, two weeks after oocyte collection. These results suggest that a single determination of the plasma beta human chorionic gonadotrophin concentration beginning 14 days after oocyte collection is clinically useful in predicting the outcome of pregnancy achieved by in vitro fertilisation. Ectopic pregnancy after in vitro fertilisation is more likely when beta human chorionic gonadotrophin concentration is below the lower quartile of values in ongoing singleton pregnancies achieved by the technique.

Chorionic Gonadotropin↗
PubMed1987

Relaxin in human pregnancy serum measured with an homologous radioimmunoassay.

This study reports serum levels of relaxin in normal and special-interest pregnancies using an homologous radioimmunoassay for human relaxin. The mean levels in uncomplicated antenatal patients were lower than those reported in studies using heterologous assays, but the trend in serum levels was similar. Serum levels peaked at ten weeks' gestation and decreased progressively to term. Relaxin was detectable in all pregnant subjects assessed at the time of the first missed menses. The mean relaxin levels in patients having in vitro fertilization and embryo transfer who subsequently delivered a single infant were significantly higher than those in normal antenatal patients at an equivalent gestational age. Patients with twin pregnancies after in vitro fertilization and embryo transfer generally had higher levels than patients with single pregnancies. Some pregnant patients who aborted after in vitro fertilization and embryo transfer had declining levels of relaxin before 40 days postlaparoscopy.

Embryo Transfer↗
PubMed1986

Attitudes towards oocyte and embryo donation and disposal.

The attitudes of In Vitro Fertilization (IVF) patients, their relatives, and their friends towards oocyte and embryo donation and disposal of frozen embryos were determined by questionnaire. The results obtained from a group of patients undergoing IVF treatment in the hospital were compared and some differences in attitudes were detected. Most respondents find embryo research and the creation of embryos, especially for research, acceptable under some circumstances and this contrasts with current Victorian legislation.

Adult↗
PubMed1986

An analysis of plasma estradiol concentrations during clomiphene citrate-human menopausal gonadotropin stimulation in an in vitro fertilization-embryo transfer program.

We report here a range of plasma estradiol (E2) concentrations suitable for use in an in vitro fertilization (IVF) program. This range was derived from nonparametric analysis of plasma E2 levels using plasma E2 measurements beginning 10 days before the anticipated day of the midcycle LH surge (midpoint), as calculated from each patient's six previous menstrual cycles, during which time the patients all received the same ovarian stimulation regimen. The regimen consisted of 100 mg clomiphene citrate/day for 5 days, beginning 10 days before the anticipated midpoint, plus 150 IU human menopausal gonadotropin, commencing the day after clomiphene. A consecutive series of 102 IVF conception cycles induced in this standardized fashion were analyzed in this study. The 5th-95 percentile envelope of plasma E2 concentrations was derived as a valid clinical indicator of satisfactory folliculogenesis during IVF treatment. Five women had plasma E2 concentrations below the 5th percentile of the E2 range on at least 3 consecutive days of ovarian stimulation, while six women had E2 levels above the 95th percentile of this range on at least 3 consecutive days. This plasma E2 range defined objectively the diagnoses of ovarian hyperstimulation and inadequate stimulation in an IVF program. These criteria should help clinicians in managing ovarian responses during IVF superovulation stimulation treatment.

Clomiphene↗
PubMed1983

T helper lymphocyte depression in early human pregnancy.

Peripheral blood lymphocyte subclasses were determined in 60 women with normal pregnancies, 20 from each trimester, and in 20 controls using automated flow cytofluorimetry. The cells were stained with the monoclonal antibodies OKT3, OKT4 and OKT8 to stain total T cells, T helper and T suppressor-cytotoxic lymphocytes, respectively. A polyvalent rabbit anti-human Ig serum was used to stain B lymphocytes. Absolute numbers of T lymphocytes were significantly reduced in both the first and second trimesters. This was due to a significant decrease in T helper lymphocytes and a smaller, statistically not significant, reduction in the number of T suppressor lymphocytes. There was no significant change in lymphocyte subclasses during the third trimester. Total lymphocyte numbers were normal throughout pregnancy.

Antibodies, Monoclonal↗
PubMed1978

Responses of Australian patients with gynaecological disorders to the General Health Questionnaire: a factor analytic study.

One hundred and twenty-seven out-patients attending a gynaecology clinic completed the General Health Questionnaire (GHQ, 60-item version) and a role problems checklist (RPCL). Principal factors analysis of the GHQ yielded 8 factors which were named: poor performance (which accounted for 63.3% of total variance), depression-anxiety, sleep-disturbance, anhedonia anergia, loss of confidence, general illness, social dysfunction and headache. These results were compared with previous principal components analyses of the GHQ (Goldberg, 1972; Goldberg et al. 1976). A multiple regression analysis indicated that age and 7 of the 8 factors were significantly related to the number of role problems reported by the patients. However, it appears that psychiatric distress (as measured by the GHQ) and role problems were only related to a small degree (multiple R2 = 12.69% only).

Anxiety↗